Pulse oximetry for monitoring infants in the delivery room: a review
Pulse oximetry for monitoring infants in the delivery room: a review
复制标题
DOI：
10.1136/adc.2006.102749
复制
发表时间：
2007-01-01
影响因子：
4.4
通讯作者：
Morley, C. J.
中科院分区：
文献类型：
--
作者：
Dawson, J. A.;Davis, P. G.;Morley, C. J.
在生命的最初几分钟，血氧饱和度（脉搏血氧饱和度，SpO 2）从分娩时的30- 40%水平增加。1在由国际复苏联络委员会、2欧洲复苏委员会3和澳大利亚复苏理事会4发布的新生儿复苏算法中，婴儿颜色（氧合测量）和心率的临床评估被用作主要行动点。然而，研究表明，在新生儿过渡期的颜色的临床评估是不可靠的。5 6奥唐纳等人6表明，观察者认为婴儿是粉红色的SpO 2变化很大，范围从10%到100%。评估颜色是困难的，因此在生命的最初几分钟内是组织氧合的一个很差的代表。kattwinkel 7建议脉搏血氧仪可能有助于实现产房的正常血氧。美国心脏协会8建议，“在脉搏血氧仪的指导下给予可变浓度的氧气可以更快地提高达到正常血氧的能力”。尽管在新生儿过渡期内“正常血氧”和达到这一目标的可接受时间尚未确定，但Leone和Finer 9主张“除特殊情况外，所有婴儿出生后3分钟的SpO 2均应达到85 - 90%”-例如，疝气或紫绀型先天性心脏病。国际调查显示，血氧饱和度越来越多地用于新生儿复苏。10 11到目前为止，还没有使用血氧测定法测量婴儿SpO 2和指导出生后新生儿过渡期干预的循证指南。我们回顾了文献，以评价出生后立即使用SpO 2测量的证据。
During the first few minutes of life, oxygen saturation (saturation by pulse oximetry, SpO2) increases from intrapartum levels of 30–40%. 1 In algorithms for neonatal resuscitation published by the International Liaison Committee for Resuscitation, 2 European Resuscitation Council3 and Australian Resuscitation Council, 4 clinical assessment of an infant’s colour (a measure of oxygenation) and heart rate are used as major action points. However, studies have shown that clinical assessment of colour during neonatal transition is unreliable. 5 6 O’Donnell et al6 showed that the SpO2 at which observers perceived infants to be pink varied widely, ranging from 10% to 100%. Assessing colour is difficult and therefore is a poor proxy for tissue oxygenation during the first few minutes of life. Kattwinkel7 suggested pulse oximetry may help achieve normoxia in the delivery room. The American Heart Association8 suggests that ‘‘administration of a variable concentration of oxygen guided by pulse oximetry may improve the ability to achieve normoxia more quickly’’. Although ‘‘normoxia’’and an acceptable time to achieve this during neonatal transition have not been defined, Leone and Finer9 advocate a target ‘‘SpO2 of 85 to 90% by three minutes after birth for all infants except in special circumstances’’—for example, diaphragmatic hernia or cyanotic congenital heart disease. International surveys show that oximetry is increasingly used during neonatal resuscitation. 10 11 To date, there are no evidence-based guidelines for using oximetry to measure an infant’s SpO2 and to guide interventions during neonatal transition after birth. We reviewed the literature to evaluate the evidence on the use of SpO2 measurements immediately after birth.