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      Saturación arterial de oxígeno y frecuencia cardíaca en recién nacidos de término sanos durante la primera hora post nacimiento Translated title: Arterial oxygen saturation and heart rate in term newborn in the first hour after birth

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          Abstract

          Resumen: Introducción: El oxímetro de pulso ha sido útil en la evaluación cardiorrespiratoria del neonato. Objetivo: Evaluar la saturación arterial de oxígeno (SpO2) y frecuencia cardíaca (FC) en recién nacidos (RN) en los pri meros 60 minutos después del nacimiento. Pacientes y Método: Estudio observacional prospectivo en RN de término sanos, nacidos por vía vaginal o cesárea, con apego materno, efectuado a nivel del mar. Se obtuvo registro continuo de SpO2 post-ductal y de FC desde el minuto 1 al 10 post-natal, y luego a los 15, 30 y 60 minutos. La SpO2 y FC se midieron con un oxímetro de pulso Nellcor. Para el análisis estadístico se utilizó programa Stata v.14. Resultados: Se enrolaron 324 RNT sanos, que cum plieron criterios de inclusión, de los cuales 160 nacieron por vía vaginal y 164 por cesárea. La SpO2 aumentó progresivamente desde el minuto 1 (58,7%) hasta el minuto 10 (94,5%). Los RN por vía vaginal presentaron una SpO2 significativamente mayor hasta el minuto 10 post-natal respecto a los nacidos por cesárea (p < 0,001). En los neonatos nacidos por vía vaginal, la FC fue significativamente mayor en los 2 primeros minutos post-natales, y luego desde el minuto 10 al 60 (p < 0,003). No se encontraron diferencias por género en SpO2 y FC. Conclusión: En RNT la SpO2 post-natal aumenta progresivamente, siendo mayor en los primeros 10 minutos en los nacidos por vía vaginal. En los RN por vía vaginal se observó también una FC mayor en los primeros y últimos minutos evaluados.

          Translated abstract

          Abstract: Introduction: The pulse oximeter has been useful in the cardiorespiratory evaluation of the newborn. Objective: To assess arterial oxygen saturation (SpO2) and heart rate (HR) in newborns in the first 60 minutes after birth. Patients and Method: Prospective observational study in healthy term newborns, delivered vaginally or by cesarean section, with maternal bonding, carried out at sea level. A continuous post ductal SpO2 and HR record were obtained from minute 1 to 10 after birth, and then at 15, 30 and 60 minutes. The SpO2 and HR were measured with a Nellcor pulse oximeter. The software Stata v.14 was used for the statistical analysis. Results: 324 healthy term newborns that met the inclusion criteria were included, of which 160 born vaginally and 164 by cesarean section. The SpO2 increased progres sively from minute 1 (58.7%) to minute 10 (94.5%). Newborns delivered vaginally had a significantly higher SpO2 until minute 10 after birth than those born by cesarean section (p < 0.001). In newborns delivered vaginally, HR was significantly higher in the first two minutes after birth, and then from minute 10 to 60 (p < 0.003). There were no differences by gender in SpO2 and HR. Conclusion: In term newborns, the SpO2 increases progressively, being higher in the first 10 minutes in those born vaginally. In newborns delivered vaginally, a higher HR was also observed in the first and last minutes evaluated.

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          Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

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            Oxygen saturation in healthy infants immediately after birth.

            Because the optimal concentration of oxygen (FiO2) required for stabilization of the newly born infant has not been established, the FiO2 is commonly adjusted according to the infant's oxygen saturation (SpO2). We aimed to determine the range of pre-ductal SpO2 in the first minutes of life in healthy newborn infants. We applied an oximetry sensor to the infant's right palm or wrist of term and preterm deliveries immediately after birth. Infants who received any resuscitation or supplemental oxygen were excluded. SpO2 was recorded at 60 second intervals for at least 5 minutes and until the SpO2 was >90%. A total of 205 deliveries were monitored; 30 infants were excluded from the study. SpO2 readings were obtained within 60 seconds of age from 92 of 175 infants (53%). The median (interquartile range) SpO2 at 1 minute was 63% (53%-68%). There was a gradual rise in SpO2 with time, with a median SpO2 at 5 minutes of 90% (79%-91%). Many newborns have an SpO2 <90% during the first 5 minutes of life. This should be considered when choosing SpO2 targets for infants treated with supplemental oxygen in the delivery room.
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              Oxygen saturation trends immediately after birth.

              To describe the changes in oxygen saturation (SpO2) in healthy infants during the first 10 minutes of life. In this observational study, infants > or = 35 weeks gestation at birth who did not require supplemental oxygen had continuous recordings taken of the preductal SpO2 over the first 10 minutes of life. A total of 115 infants were analyzed. On average, infants delivered by cesarean delivery had a 3% lower SpO2 than infants delivered by vaginal delivery (95% confidence interval [CI] = -5.8 to -0.7; P = .01). Infants born by cesarean delivery also took longer (risk ratio, 1.79) to reach a stable SpO2 > or = 85% (95% CI = 1.02 to 3.14; P = .04). At 5 minutes of age, median SpO2 values (interquartile range) were 87% (80% to 95%) for infants delivered vaginally and 81% (75% to 83%) for those delivered through cesarean section. The median SpO2 did not reach 90% until 8 minutes of age in either group. The process of transitioning to a normal postnatal oxygen saturation requires more than 5 minutes in healthy newborns breathing room air.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rcp
                Revista chilena de pediatría
                Rev. chil. pediatr.
                Sociedad Chilena de Pediatría (Santiago, , Chile )
                0370-4106
                August 2019
                : 90
                : 4
                : 384-391
                Affiliations
                [2] Concepción orgnameHospital Guillermo Grant Benavente orgdiv1Servicio Neonatología Chile
                [3] Bío-Bío orgnameUniversidad de Concepción orgdiv1Facultad de Medicina orgdiv2Departamento Obstetricia y Ginecología Chile
                [1] Bío-Bío orgnameUniversidad de Concepción orgdiv1Facultad de Medicina orgdiv2Departamento Pediatría Chile
                Article
                S0370-41062019000400384
                10.32641/rchped.v90i4.964
                aa2983f8-542f-4290-bfcf-bde63b531b5c

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 19 November 2018
                : 28 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 8
                Product

                SciELO Chile

                Categories
                ARTÍCULOS ORIGINALES

                Saturación de oxígeno,oximetría de pulso,frecuencia cardiaca,recién nacido de término,Oxygen saturation,pulse oximetry,heart rate,term newborn

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