Original ArticlePulse Oximetry Measures a Lower Heart Rate at Birth Compared with Electrocardiography
Section snippets
Methods
This prospective observational study was conducted in the Department of Neonatology of the Leiden University Medical Center, Leiden, The Netherlands, with approval from the institutional review board. Informed parental consent was asked before birth. In the event this was deemed not suitable (eg, because of the clinical condition of the mother), permission to use the data was asked after birth. Permission was acquired both verbally and in writing. Term and preterm infants born vaginally or by
Results
Data were collected from 52 infants, of which 4 infants were excluded because of technical problems with the PO or PO data that were not collected. Of the 48 infants included in the analyses, paired HR measurements were compared every 30 seconds (in total 755 data pairs). In 14 infants, the initiation of cardiac contraction was demonstrated by a Doppler flow profile over the left ventricular outflow tract assessed using ultrasonography following an ECG-complex. The mean (SD) time taken to
Discussion
We measured HRECG and HRPO in infants during the first 10 minutes after birth. Using Doppler measurements, we confirmed that each QRS complex, detected by ECG, was associated with a ventricular contraction and subsequent cardiac output. However, we observed that until 7 minutes after birth, HRPO was significantly lower than HRECG. As ECG is the gold standard, our findings imply that PO underestimates HR compared with ECG in the first minutes after birth. Although HRPO starts low and increased
References (19)
- et al.
Accuracy of pulse oximetry measurement of heart rate of newborn infants in the delivery room
J Pediatr
(2008) - et al.
Feasibility of and delay in obtaining pulse oximetry during neonatal resuscitation
J Pediatr
(2005) - et al.
Time to achieve stable pulse oximetry values in VLBW infants in the delivery room
Resuscitation
(2013) - et al.
Delivery room intervention: improving the outcome
Clin Perinatol
(2010) - et al.
Auditing resuscitation of preterm infants at birth by recording video and physiological parameters
Resuscitation
(2012) - et al.
Part 15: neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Circulation
(2010) - et al.
Changes in heart rate in the first minutes after birth
Arch Dis Child Fetal Neonatal Ed
(2010) - et al.
Noninvasive measurements of hemodynamic transition directly after birth
Pediatr Res
(2014) - et al.
Electrocardiogram provides a continuous heart rate faster than oximetry during neonatal resuscitation
Pediatrics
(2012)
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A.tP. is recipient of a Veni-grant, The Netherlands Organization for Health Research and Development (ZonMw), part of the Innovational Research Incentives Scheme Veni-Vidi-Vici (91612027). J.vV. is recipient of a Willem-Alexander Children's Foundation scholarship. The authors declare no conflicts of interest.