The Role of Pulse Oximetry in Resuscitation of Asphyxiated Neonates

Abstract

Pulse oximetry has emerged as a convenient and readily available tool for monitoring of resuscitation. This study was done to evaluate the ability of the pulse oximetry to record oxygen saturation of asphyxiated neonates as well to note serial changes in oxygen saturation during their resuscitation. The main outcome was time taken to reach 90% saturation as recorded by pulse oximeter. The other variables were the time when first recording could be taken by pulse oximeter and time taken to reach 75% saturation. 100 cases (asphyxiated newborns) and 30 controls (normal newborns) were included in the study. The mean heart rate at one minute of age was significantly lower in the asphyxiated group (91+/-5.24 per minute) as compared to controls (125.2+/-4.5 per minute). The mean oxygen saturation at one minute of age was also significantly lower for asphyxiated group (47.5%+/-1.42) as compared to controls (50.5%+/-2.08). The median (inter quartile range) time taken in seconds to reach 75% and 90% saturation was 290 (275-295) and 490(480-510) seconds in the asphyxiated group was significantly higher (p<0.05) as compared to controls where it was 205 (190-212) and 375 (357-398). Both Asphyxiated and normal newborns remain relatively desaturated in early minutes of life. Pulse oximetry could detect these significant differences in the oxygen saturation and heart rate during initial periods of resuscitation, but as resuscitation continued these differences became non significant indicating the adequacy of resuscitation in asphyxiated newborn. This can be utilized as a cost effective tool in the neonatal unit in peripheral centers with less facilities in developing countries as ours to check for adequacy of resuscitation and intensive care referrals if needed, particularly for the primary care physicians who need to be well versed about the adequacy of resuscitation.