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Defining the “normal” range for oxygen saturation in newly born infants

Presented at the Neonatal Society 2009 Summer Meeting (programme).

Dawson JA1,2,3, Kamlin COF1, Vento M4, Wong C1, Donath SM2,3, Davis PG1,2,3, Morley CJ1,2,3

1 Neonatal Research, Royal Women’s Hospital, Locked Bag 20, Parkville, VIC, Australia
2 University of Melbourne
3 Murdoch Children’s Research Institute, Melbourne, Australia
4 Division of Neonatology, University Hospital La Fe, Valencia, Spain

Background: Pulse oximetry is increasingly used during resuscitation and stabilisation of newly born babies. Oxygen saturation (SpO2) changes over the first minutes after birth.

Aim: To define the reference range for SpO2 in the first ten minutes after birth.

Patients and Methods: Data from infants were included if they had no medical intervention in the first 10 minutes after birth (oropharyngeal suction, supplemental oxygen or assisted ventilation). SpO2 was measured with a Masimo Radical SET oximeter at maximum sensitivity and averaging every 2 sec, with a LNOP Neo sensor placed on the right hand or wrist immediately after birth. SpO2 and signal quality were downloaded every 2 sec and used, when there were no messages about data quality, using the ne02M program for the Vento and Dawson data. A program automatically inserted the time from birth. Data for the Kamlin study were collected every minute by observation.

The researcher collecting the data was not involved in the care of the infant. Parents gave verbal consent for their infant to participate.

Data from three cohorts were combined to construct 10th to 90th centile charts (Dawson n=264, Kamlin n=175, Vento n=29). The centiles were calculated using the LMS method, of Cole and fitted using the LMSchartmaker software.

Results: Data were from 468 infants; 160 <37 weeks gestation and 308 ≥37 weeks. The SpO2 median (10th, 90th centiles) were: 1 min 66% (55, 75), 2 min 73% (63, 82), 5 min 9% (82, 95) and 10 min 96% (92, 98). The figure shows the 10th, 25th, 50th 75th and 90th centiles and all infants from 1-10 min. The median (10th, 90th centile) to reach an SpO2 > 90% was 8.4 min (6.1, 10.5).

Conclusions: This is the best evidence for SpO2 changes for normal infants during the first 10 minutes after birth.

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