The target value of oxygen saturation during the first 10 minutes after birth

Background During the neonatal resuscitation, careful oxygenation is needed. The use of pulse oximetry is recommended to evaluate the need for oxygenation, but it is not clear whether adequate peripheral perfusion is established to allow the evaluation of arterial oxygen saturation (SpO2). Additionally, there is no study of the changes in SpO2 immediately after birth in Japan, despite the indispensable need for definitive oxygenation criteria. Methods A prospective observational study was performed in neonates with gestational ages of 35-41 weeks. A SpO2 measurement probe was attached to the neonates immediately after birth at right palm or wrist, and the perfusion index (PI), pulse rate, and SpO2 were measured until 10 minutes after birth. Results Sixty neonates were examined. Stable PI values were obtained soon after birth, preceding SpO2 measurement. The median PI (%) was constant at approximately 1.3, and the median SpO2 values (%) at 2-10 minutes were 70, 81, 82, 87, 89, 92, 92, 94, and 95, respectively. The current target value for SpO2 in Neonatal Cardio Pulmonary Resuscitation (NCPR) guideline in Japan was at approximately the 25th percentile. Conclusion The finding of stable and sufficient PI in the early postnatal period proved that peripheral perfusion was adequate to allow the measurement of SpO2. The current target SpO2 used in NCPR guideline was at approximately the 25th percentile and was thought to be beneficial for oxygenation criteria. This article is protected by copyright. All rights reserved.