Time Taken to Reach Target Saturation and Color of Tongue and Trunk in Determining Supplemental Oxygen Requirement

Reeta Bora, Nibedita Paul, Subhamitra Lashkar, Manjit Baruah

This paper was presented at the IAP Neonatology Chapter’s Annual Conference 2016 and was adjudged the best paper.


Objectives: To determine the time taken by neonates to reach target pulse oxygen saturations (SpO2) > 70% and > 90% and to assess if the appearance of pink color of tongue and trunk coincides with an SpO2 > 70%

Materials and Methods: This study included 352 term and preterm neonates not requiring any intervention at birth. All neonates were placed under a radiant warmer. One investigator recorded the pulse oximeter data every minute until 10 minutes after birth. Simultaneously, another investigator assessed and recorded the time of appearance of pink color of the tongue and trunk. Data were statistically analyzed.

Results: The median time required to attain > 70% SpO2 levels was 3 minutes with significant differences between term and preterm neonates. Median time required to attain saturation > 90% in term and preterm neonates was 5 minutes. The sensitivity and specificity of pink color of tongue and trunk to predict SpO2 > 70% were 97.03% and 0.80% and 89.6% and 0.4%, respectively.

Conclusion: Preterm neonates have lower saturation at birth and take longer than term neonates to achieve an SpO2 > 70%. Median time required to attain > 90% SpO2 is same for all neonates. The tongue and trunk color has poor specificity in detecting > 70% SpO2; thus, emphasizing the importance of having pulse oximeters in delivery rooms.

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