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Oct 8, 2018

7th Congress of the European Academy of Paediatric Societies

04 - OXYGEN SATURATION AND HEART RATE DURING PHYSIOLOGY BASED CORD CLAMPING IN PRETERM INFANTS AT BIRTH

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neonatology

physiology

resuscitation

circulatory

respiratory

Abstract

Abstract

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Keywords

neonatology

physiology

resuscitation

circulatory

respiratory

Abstract

Introduction: Experimental studies in preterm lambs showed physiology based cord clamping (PBCC), deferring cord clamping until after ventilation and lung aeration, avoids large disturbances in systemic and cerebral hemodynamics that occur with immediate cord clamping. This study aims to measure oxygen saturation and heart rate (HR) in the first 10 minutes during stabilisation of preterm infants, in a feasibility study where PBCC was performed. Methods: Infants were stabilized on a purpose built resuscitation table (Concord), provided with standard equipment needed for stabilization. PBCC was performed when the infant was considered stable (HR >100 bpm, spontaneous breathing on CPAP with tidal volumes > 4mL/kg, SpO2 ≥ 25th percentile and fraction of inspired oxygen (FiO2) <0.4). Results: In 20/26 infants with GA < 32 weeks, measurements were adequate for analysis (mean (SD) GA of 29.8 (1.6) weeks, birth weight 1341 (293) grams). All infants were supported by positive pressure ventilation and/or CPAP. The umbilical cord was clamped at a median (IQR) time of 4:20 (2:50-6:53) min:sec. Median (IQR) HR was 123 (89-148), 127 (96-137), 134 (112-148) and 144 (128-155) bpm at 1, 2, 3 and 5 minutes after birth, SpO2 was 54% (46%-67%), 58 (47-82), 79% (57%-91%) and 92% (84%-97%) respectively. HR did not change around the time of PBCC, with a HR of 140 (127-152) bpm. Conclusion: HR and SpO2 measurements of very preterm infants at birth where PBCC was performed, were comparable to the findings in experimental setting. HR was more stable and SpO2 increased faster with less extra oxygen than described up till now in very preterm infants.

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© Copyright 2019 Morressier GmbH.
All rights reserved.