The Journal of Pediatrics
Volume 152, Issue 6 , Pages 756-760, June 2008

Accuracy of Pulse Oximetry Measurement of Heart Rate of Newborn Infants in the Delivery Room

  • C. Omar F. Kamlin, MBBS, MRCPCH

      Affiliations

    • Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
    • Corresponding Author InformationReprint requests: C. Omar F. Kamlin, Neonatal Paediatrician, Division of Newborn Services, The Royal Women's Hospital, 132 Grattan St, Carlton, Victoria, Australia, 3053.
    • ,
  • Jennifer A. Dawson, BSc

      Affiliations

    • Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
    • ,
  • Colm P.F. O'Donnell, MRCPCH, PhD

      Affiliations

    • Neonatal Unit, National Maternity Hospital, Dublin, Ireland
    • ,
  • Colin J. Morley, MD, FRACP

      Affiliations

    • Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
    • Department of Obstetrics, University of Melbourne, Melbourne, Australia
    • Murdoch Children's Research Institute, Melbourne, Australia.
    • ,
  • Susan M. Donath, PhD

      Affiliations

    • Department of Obstetrics, University of Melbourne, Melbourne, Australia
    • Murdoch Children's Research Institute, Melbourne, Australia.
    • ,
  • Jasbir Sekhon

      Affiliations

    • Department of Obstetrics, University of Melbourne, Melbourne, Australia
    • ,
  • Peter G. Davis, MD, FRACP

      Affiliations

    • Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
    • Department of Obstetrics, University of Melbourne, Melbourne, Australia

Received 16 July 2007; received in revised form 25 October 2007; accepted 3 January 2008. published online 07 March 2008.

Objective

To determine the accuracy of heart rate obtained by pulse oximetry (HRPO) relative to HR obtained by 3-lead electrocardiography (HRECG) 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, 1 of the investigators recorded HRPO and indicators of signal quality from the oximeter while masked to ECG, whereas the other recorded HRECG and ECG signal quality while masked to PO. HRPO and HRECG 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 HRECG and HRPO 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 HRECG <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.

Abbreviations: bpm, Beats per minute, ECG, Electrocardiography, HR, Heart rate, PO, Pulse oximetry, SD, Standard deviation

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Supported in part by a RWH Postgraduate degree scholarship (C.O., C.K., J.D.) an NHMRC Practitioner Fellowship (P.D.), and an Australian National Health and Medical Research Council Program grant (384100).

PII: S0022-3476(08)00003-6

doi:10.1016/j.jpeds.2008.01.002

Refers to article:

  • Physical Examination and Pulse Oximetry in Newborn Infants: Out with the Old, in with the New?

    William T. Mahle
    The Journal of Pediatrics June 2008 (Vol. 152, Issue 6, Pages 747-748)

  • First Day of Life Pulse Oximetry Screening to Detect Congenital Heart Defects , 07 March 2008

    Alf Meberg, Sabine Brügmann-Pieper, Reidar Due, Leif Eskedal, Ingebjørg Fagerli, Teresa Farstad, Dag Helge Frøisland, Catharina Hovland Sannes, Ole Jakob Johansen, Jasmina Keljalic, Trond Markestad, Egil Andre Nygaard, Alet Røsvik, Inger Elisabeth Silberg
    The Journal of Pediatrics June 2008 (Vol. 152, Issue 6, Pages 761-765)

The Journal of Pediatrics
Volume 152, Issue 6 , Pages 756-760, June 2008

Article Tools

* Image Usage & Resolution