Oxygen Saturation in Neonate after Birth

Background: Oxygen saturation measures the quantity of haemoglobin in the blood that is saturated with oxygen. Hemoglobin is a component of red blood cells that binds oxygen and transports it to outlying tissues. Oxygen is commonly used throughout the world in neonatal units. Injudicious use of Oxygen may not maintain appropriate oxygen status rather can lead to hypoxemia or hyperoxemia, both of the conditions are injurious to neonatal health. Objective: To assess the oxygen saturation in neonate after birth.Methods:A cross-sectional study conducted in the Department of Neonatology BSMMU, Shahbag, Dhaka, Lab Aid Specialized Hospital, Dhaka, Bangladesh from October 2013 to March 2014. A total 317 patients were selected according to selection criteria. The parents were interviewed with a specific pre-designed and pre-tested questionnaire and some information were gathered by document review. All neonate both term and late preterm (˃34weeks) who would not be anticipated for resuscitation was included.Results:A total 317 neonate were selected according to selection criteria. Among the study subjects more than half were male (57.1%). Rests were female (42.9%). Average gestational age of the study subjects was 37.47± 1.16 (SD) with the range of 34-40. On the other hand average birth weight was 2.88±0.46 (SD) with the minimum birth weight 2.0 kg and maximum weight 4.2 kg. Illustrates the median (IQR) heart rate from one to ten min for preterm versus term births. At one to three minutes and at five minutes after birth preterm infants had significantly lower SpO2 measurements. From six to 10 minutes after birth and four minutes after birth there was no significant difference between SpO2 measurements for mode of delivery. Paired sample t test showed that average SpO2 was less in 1 minute[88.42±4.8(SD)] than in 5 minute [94.25±3.5(SD)] and statistically this differences were highly significant (t=24.44, p=0.000). Pearson correlation showed high positive correlation (p=0.000) and correlation co-efficient r=0.479. Correlation was significant at the 0.01 level.Conclusion:It is “normal” to have low oxygen saturation measurements in the first minutes after birth. It takes time for infants to reach oxygen saturation levels described as “normal” in the later postnatal period. Oxygen saturation increased with time i.e., it was more in 5 minutes than in 1 minute and similarly more in 10 minutes than in 5 minutes. Conversely heart rate was found more in one minute than to five and ten minutes. Oxygen saturation was ≥ 90% within 3 to 4 minutes. Significant changes were found in Oxygen saturation by mode of delivery in three minutes & in heart rate by two minutes after birth. At one to ten minutes after birth preterm infants had lower SpO2 measurements.

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Changes in the physiological parameters of newborns in the first one hour of life

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192751 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1533

Author(s):

Shasidhar Reddy Y. ◽

Abdul Mohid Syed ◽

Gangadhar B. Belavadi

Keyword(s):

Heart Rate ◽

Birth Weight ◽

Low Birth Weight ◽

Oxygen Saturation ◽

Mode Of Delivery ◽

Physiological Parameters ◽

Peripheral Oxygen Saturation ◽

College Hospital ◽

Significant Difference ◽

The Mean

Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.

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Abstract 14185: Targeting Lower Oxygen Saturation Parameters in Premature Infants Does Not Increase Incidence of Pulmonary Hypertension in the Neonatal Intensive Care Unit

Circulation ◽

10.1161/circ.142.suppl_3.14185 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Maria Niccum ◽

Fotios Spyropoulos ◽

Jonathan Levin ◽

Carter Petty ◽

Mary P Mullen ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Logistic Regression ◽

Birth Weight ◽

Oxygen Saturation ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Positive Association ◽

Increased Risk ◽

Significant Difference ◽

Lower Oxygen

Introduction: Lower oxygen saturation targets in preterm infants have been associated with decreased incidence of bronchopulmonary dysplasia (BPD) but increased risk of pulmonary hypertension (PH). Studies have shown that targets of <90% are associated with higher incidence of PH, however data on the optimal saturation target >90% are lacking. In this study, we compared the rate of BPD and PH in two cohorts with saturation targets of 94-98% and 92-97%. We hypothesized that BPD rate would be lower and PH rate would be unchanged at the lower saturation target. Methods: We performed a retrospective cohort study comparing PH and BPD rates among two cohorts of infants born at ≤32 weeks gestation at Brigham and Women’s Hospital: cohort 1 with saturation target of 94-98% (n = 129, July 2017-July 2018), cohort 2 with saturation target of 92-97% (n = 124, July 2018-July 2019). PH was defined by echocardiographic evidence of systolic septal flattening or right ventricular pressure ≥35 mmHg (estimated by tricuspid regurgitant jet velocity or shunt velocity) at gestational age (GA) ≥36 weeks. Comparisons between groups were carried out by Chi-square test, t-test, and multivariable logistic regression. Results: Subjects had a GA of 23-32 weeks; 46% were female. Groups did not differ with respect to GA, sex, or birth weight. There was no difference in rate of PH (2.4% vs. 4.2%, p = 0.12) or BPD (25% vs. 20%, p = 0.31) between cohort 1 and cohort 2. Other clinical parameters were not different between groups, including presence of patent ductus arteriosus, presence of atrial septal defect, use of diuretics, or use of steroids. After controlling for GA, birth weight, sex, and diagnosis of BPD using logistic regression, there was no difference in rate of PH between groups (p = 0.47), but there was a positive association of BPD with PH (OR 3.45; 95% CI, 1.18-10.09; p = 0.02). Conclusions: A lower oxygen saturation target was not associated with a higher rate of PH or lower rate of BPD in preterm infants. The overall rate of PH was much lower than rates previously reported at saturation targets <90%. Given our low incidence of PH, and the lack of a significant difference in rate of PH between groups, a saturation target of 92-97% may be safe while also minimizing need for supplemental oxygen in this population.

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The Effect of Kangaroo Care on Pain and Physiological Parameters in Preterm Infants on Heel-stick Procedure: A Randomized Controlled, Cross-over Study

Galen Medical Journal ◽

10.31661/gmj.v2i4.80 ◽

2013 ◽

Vol 2 (4) ◽

pp. 157-168

Author(s):

Noushin Beheshtipoor ◽

Ashraf Memarizadeh ◽

Fatemeh Hashemi ◽

Shahnaz Porarian ◽

Masoume Rambod

Keyword(s):

Heart Rate ◽

Oxygen Saturation ◽

Preterm Infants ◽

Physiological Parameters ◽

Kangaroo Care ◽

Randomized Controlled ◽

Significant Difference ◽

Acceleration And Deceleration ◽

And Control ◽

Intervention Condition

Background: Due to the higher risk of pain in preterm infants, pain management is important for such infants. The present study aimed to determine the effectiveness of kangaroo care on the severity of pain and physiological parameters after heel-stick in preterm infants. Materials and Methods: This was a prospective and randomized controlled cross-over study. Twenty preterm infants allocated into an intervention (30 minutes of kangaroo care before and throughout heel-stick) and a control condition (standard incubator care during heel-stick). The severity of pain and the physiological parameters (heart rate and oxygen saturation) were collected after the heel-stick procedure. Results: The pain mean scores in the intervention and control conditions were respectively 4.9 (SD=2.91) and 11.00 (SD=4.21) and a significant difference was found between the two conditions regarding the pain score 30 seconds after the heel-stick [t=5.33, p<0.001]. Moreover, a significant difference between the two conditions concerning the infants' heart rate (F=3.73, p<0.0001) and oxygen saturation (F=1.84, p<0.0001) was demonstrated during the three study periods. Conclusion: In order to relieve the preterm infants' pain and prevent quick acceleration and deceleration of heart rate and oxygen saturation in the intervention condition, the intervention is recommended to be done in a nursery.

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A Comparative study between Dexmedetomidine versus Propofol for sedation in upper GI endoscopy procedure considering effect on intraoperative vital data, patient amnesia and onset of recovery after the procedure

QJM ◽

10.1093/qjmed/hcab086.025 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Eslam Ahmed Mohamed Elsamahi ◽

Bassem P Ghobrail ◽

Ghada Mohamed Samir ◽

Hany Victor Zaki

Keyword(s):

Heart Rate ◽

Oxygen Saturation ◽

Respiratory Rate ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Endoscopy ◽

Day Case ◽

Upper Gi ◽

Significant Difference ◽

Upper Gi Endoscopy ◽

Upper Gastrointestinal

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P < 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P < 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.

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MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

Paediatrics & Child Health ◽

10.1093/pch/pxy054.069 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e27-e27

Author(s):

Sarah McKnight ◽

Bishal Gautam ◽

Michael Miller ◽

Bryan S Richardson ◽

Orlando da Silva

Keyword(s):

Caesarean Section ◽

Preterm Infants ◽

Periventricular Leukomalacia ◽

Ductus Arteriosus ◽

Tertiary Care ◽

Mode Of Delivery ◽

Breech Presentation ◽

Neonatal Outcomes ◽

Care Hospital ◽

Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

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Investigation of Cardiovascular Endurance Levels of Sedentary High School Students

Journal of Education and Training Studies ◽

10.11114/jets.v6i5.3039 ◽

2018 ◽

Vol 6 (5) ◽

pp. 144

Author(s):

Betül Akyol ◽

Kayhan Söğüt

Keyword(s):

High School ◽

Heart Rate ◽

High School Students ◽

Oxygen Saturation ◽

Recovery Period ◽

Step Test ◽

School Students ◽

Walking Test ◽

Cardiovascular Endurance ◽

Significant Difference

The aim of our study is to examine the cardiovascular endurance systems of sedentary high school students. The 112 sedentary individual was taken to the 1600 meter walking test run, and the 120 sedentary individual Harward step test. While both individuals were participating in the same test, weight, height, oxygen saturation, and heart rate of participants were measured before starting the test. As soon as the test is finished (recovery period), oxygen saturation and heart rate variability of individuals are measured at 1, 3, 5 minutes. All measured variables were analyzed and compared. Analysis of the data was done according to the SPSS statistical program and the significance level was accepted as p <0.05. In the 1600-meter walking test, it was observed that there was a significant difference in mean heart rate between males and females p<0.05. There was a significant difference between the mean values of the time of completion of the 1600 m running test by males and females (p < 0.05). During the 1600-meter walking and Harward step test recovery period, there was no difference in the participants' parameters. There was no significant difference between oxygen saturations at beginning, recovery 1st, 3rd, and 5th minutes in both tests. Significant differences were found between heart rate and oxygen saturation values (beginning, recovery 1st, 3rd, and 5th minutes) in the intra-group comparisons of both groups. Participants' heart rates began to increase with exercise, but remained above the initial heart rate level during recovery. Participants' body mass indexes were observed to be within normal values. We think that can be increased cardio respiratory and cardiovascular fitness levels and can been created lifelong exercise habits by regular exercise programs are given to Sedentary high school students. Thus, we believe that the young population can be prevented from getting sick by providing healthier, social, active individuals.

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Correlation of Retinopathy of Prematurity with Oxygen Saturation

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i06/1124 ◽

2021 ◽

Vol 6 (06) ◽

pp. 391-392

Author(s):

Praveen S ◽

Waris A

Keyword(s):

Birth Weight ◽

Oxygen Saturation ◽

Preterm Infants ◽

Retinopathy Of Prematurity ◽

Oxygen Therapy ◽

Prolonged Exposure ◽

Supplementary Oxygen ◽

Childhood Blindness ◽

Lower Oxygen ◽

Proliferative Disease

Retinopathy of prematurity (ROP) is an abnormal vascular proliferative disease of retina that affects preterm infants. It is a leading cause of childhood blindness worldwide despite improvement in neonatal care and management. Earlier ROP was found to be associated with oxygen therapy only. Now it was concluded that aetiology of ROP was multifactorial but three factors have shown significant association with ROP: low gestational age (GA), low birth weight (BW), prolonged exposure to supplementary oxygen following delivery. Several investigators reported that lower oxygen saturation targets at young post-gestational ages with increased oxygen saturation targets at older post gestational ages reduced the incidence of ROP. However previous clinical studies are not conclusive.

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Changes in pregnancy outcomes during the COVID-19 lockdown in Iran

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04050-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fahimeh Ranjbar ◽

Leila Allahqoli ◽

Soheila Ahmadi ◽

Robab Mousavi ◽

Maryam Gharacheh ◽

...

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Health Care Services ◽

Mode Of Delivery ◽

Preterm Births ◽

Future Health ◽

Significant Difference

Abstract Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.

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Intratracheal Suctioning in Sick Preterm Infants: Prevention of Intracranial Hypertension and Cerebral Hypoperfusion by Muscle Paralysis

PEDIATRICS ◽

10.1542/peds.79.4.538 ◽

1987 ◽

Vol 79 (4) ◽

pp. 538-543

Author(s):

Sergio Fanconi ◽

Gabriel Duc

Keyword(s):

Heart Rate ◽

Intracranial Pressure ◽

Cerebral Perfusion Pressure ◽

Preterm Infants ◽

Cerebral Perfusion ◽

Perfusion Pressure ◽

Muscle Paralysis ◽

Endotracheal Suctioning ◽

Significant Difference ◽

Transcutaneous Po2

In a prospective nonrandomized study, using each baby as his or her own control, we compared intracranial pressure (anterior fontanel pressure as measured with the Digilab pneumotonometer), cerebral perfusion pressure, BP, heart rate, transcutaneous Po2, and transcutaneous Pco2 before, during, and after endotracheal suctioning, with and without muscle paralysis, in 28 critically ill preterm infants with respiratory distress syndrome. With suctioning, there was a small but significant increase in intracranial pressure in paralyzed patients (from 13.7 [mean] ± 4.4 mm Hg [SD] to 15.8 ± 5.2 mm Hg) but a significantly larger (P < .001) increase when they were not paralyzed (from 12.5 ± 3.6 to 28.5 ± 8.3 mm Hg). Suctioning led to a slight increase in BP with (from 45.3 ± 9.1 to 48.0 ± 8.7 mm Hg) and without muscle paralysis (from 45.1 ± 9.4 to 50.0 ± 11.7 mm Hg); but there was no significant difference between the two groups. The cerebral perfusion pressure in paralyzed infants did not show any significant change before, during, and after suctioning (31.5 ± 9.1 mm Hg before v 32.0 ± 8.7 mm Hg during suctioning), but without muscle paralysis cerebral perfusion pressure decreased (P < .001) from 32.8 ± 9.7 to 21.3 ± 13.1 mm Hg. Suctioning induced a slight decrease in mean heart rate and transcutaneous Po2, but pancuronium did not alter these changes. There was no statistical difference in transcutaneous Pco2, before, during, and after suctioning with and without muscle paralysis. Our data demonstrate that muscle paralysis in sick preterm infants can significantly minimize the increase in intracranial pressure and can stabilize the cerebral perfusion pressure without having any effect on the BP increase during suctioning.

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Factors Affecting Heart Rate Variability in Preterm Infants

PEDIATRICS ◽

10.1542/peds.65.1.50 ◽

1980 ◽

Vol 65 (1) ◽

pp. 50-56 ◽

Cited By ~ 1

Author(s):

Luis A. Cabal ◽

Bijan Siassi ◽

Bernardino Zanini ◽

Joan E. Hodgman ◽

Edward E. Hon

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Distress Syndrome ◽

Good Prognosis ◽

Factors Affecting ◽

Rate Level ◽

Heart Rate Level

Neonatal heart rate variability (NHRV) was studied in 92 preterm infants (birth weight, 750 to 2,500 gm; gestational age, 28 to 36 weeks). Each infant was monitored continuously during the first 6 hours and for one hour at 24, 48, and 168 hours of life. During each hour NHRV was quantified and related to the following parameters: sex, gestational age, postnatal age, heart rate, and the presence and severity of respiratory distress syndrome (RDS). NHRV in healthy preterm infants was inversely related to heart rate level and directly related to the infant's postnatal age. In healthy babies with gestations of 30 to 36 weeks there was no significant correlation between NHRV and gestation. Decrease in NHRV was significantly related to the severity of RDS, and the reappearance of NHRV in infants with RDS was associated with a good prognosis. Decreased NHRV significantly differentiated the infants with RDS who survived after the fifth hour of life. The data reveal that NHRV (1) should be corrected for heart rate level and postnatal age; (2) is decreased in RDS; and (3) can be used as an indicator of morbidity and mortality in preterm infants with RDS.

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