Accuracy of pulse oximetry measurement of heart rate of newborn infants in the delivery room
Accuracy of pulse oximetry measurement of heart rate of newborn infants in the delivery room
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DOI：
10.1016/j.jpeds.2008.01.002
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发表时间：
2008-06-01
影响因子：
5.1
通讯作者：
Davis, Peter G.
中科院分区：
文献类型：
--
作者：
Kamlin, C. Omar F.;Dawson, Jennifer A.;Davis, Peter G.
目的探讨在分娩室中应用脉搏血氧饱和度（PO）测量新生儿心率与3导联心电图（ECG）测量新生儿心率的准确性。通过摄像机记录PO和ECG监视器显示。两名调查人员查看了视频。每两秒钟，一名研究者记录HR（PO）和血氧计信号质量指标，同时对ECG设盲，而另一名研究者记录HR（ECG）和ECG信号质量，同时对PO设盲。HR（PO）和HR（ECG）测量值进行了比较，使用Bland-Altman analysis.Results我们参加了92分娩; 37名婴儿被排除在外，由于设备故障。研究的55名婴儿的平均（+/-标准差[SD]）胎龄为35（+/- 3.7）周，出生体重为2399（+/- 869）g。我们总共分析了5877个数据对。HR（ECG）和HR（PO）之间的平均差异（+/- 2 SD）总体为-2（+/- 26）次/分钟（bpm），接受正压通气和/或心脏按摩的婴儿为-0.5（+/- 16）次/分钟。PO检测HR（ECG）< 100 bpm的敏感性为89%，特异性为99%。结论PO可准确反映产房内新生儿的HR，包括接受深度复苏的新生儿。
Objective To determine the accuracy of heart rate obtained by pulse oximetry (HR(PO)) relative to HR obtained by 3-lead electrocardiography (HR(ECG)) in newborn infants in the delivery room.Study design Immediately after birth, a preductal PO sensor and ECG leads were applied. PO and ECG monitor displays were recorded by a video camera. Two investigators reviewed the videos. Every two seconds, I of the investigators recorded HR(PO) and indicators of signal quality from the oximeter while masked to ECG, whereas the other recorded HR(ECG) and ECG signal quality while masked to PO. HR(PO) and HR(ECG) measurements were compared using Bland-Altman analysis.Results We attended 92 deliveries; 37 infants were excluded due to equipment malfunction. The 55 infants studied had a mean (+/- standard deviation [SD]) gestational age of 35 (+/- 3.7) weeks, and birth weight 2399 (+/- 869) g. In total, we analyzed 5877 data pairs. The mean difference (+/- 2 SD) between HR(ECG) and HR(PO) was -2 (+/- 26) beats per minute (bpm) overall and -0.5 (+/- 16) bpm in those infants who received positive-pressure ventilation and/or cardiac massage. The sensitivity and specificity of PO for detecting HR(ECG) < 100 bpm was 89% and 99%, respectively.Conclusion PO provided an accurate display of newborn infants' HR in the delivery room, including those infants receiving advanced resuscitation.