AUTHOR=Bresesti Ilia , Bruckner Marlies , Mattersberger Christian , Baik-Schneditz Nariae , Schwaberger Bernhard , Mileder Lukas , Avian Alexander , Urlesberger Berndt , Pichler Gerhard 

TITLE=Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00011

DOI=10.3389/fped.2020.00011

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO<sub>2</sub>). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO<sub>2</sub>) may further offer quantitative information on neonatal respiratory status.</p><p><bold>Objective:</bold> We aimed to investigate feasibility of tcpCO<sub>2</sub> measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO<sub>2</sub> between stable term and preterm infants.</p><p><bold>Methods:</bold> Neonates without need for cardio-respiratory intervention during immediate transition after birth were enrolled in a prospective observational study. In these term and preterm neonates, we measured HR and SpO<sub>2</sub> by pulse oximetry on the right wrist and tcpCO<sub>2</sub> with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO<sub>2</sub> were analyzed in term and preterm neonates and groups were compared.</p><p><bold>Results:</bold> Fifty-three term (gestational age: 38.8 ± 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 ± 1.5 weeks) were included. First tcpCO<sub>2</sub> values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO<sub>2</sub> values 15 min after birth were 46.2 (95% CI 34.5–57.8) mmHg in term neonates and 48.5 (95%CI 43.0–54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO<sub>2</sub> values at any time point.</p><p><bold>Conclusion:</bold> This study demonstrates that tcpCO<sub>2</sub> measurement is feasible during immediate neonatal transition after birth and that tcpCO<sub>2</sub> values were comparable in stable term and preterm neonates.</p>