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. 2021 Sep;41(9):2309-2316.
doi: 10.1038/s41372-021-01029-2. Epub 2021 Mar 23.

Delivery room oxygen physiology and respiratory interventions for newborns with cyanotic congenital heart disease

Alyssa R Thomas  1 , Amy L Ma  2 , Danielle D Weinberg  2 , Matthew Huber  2 , Anne Ades  2 , Jack Rychik  3 , Elizabeth E Foglia  4
Affiliations

Delivery room oxygen physiology and respiratory interventions for newborns with cyanotic congenital heart disease

Alyssa R Thomas et al. J Perinatol. 2021 Sep.

Abstract

Objective: To characterize pulse oxygen saturation (SpO2) trajectories and respiratory interventions after birth for newborns with cyanotic congenital heart disease (CCHD).

Study design: Retrospective single-site study of newborns ≥32 weeks gestation with CCHD: single ventricle with critical aortic obstruction (SV-CAO), critical pulmonic obstruction (CPO), transposition of the great arteries (TGA). Minute-to-minute SpO2 values and respiratory interventions were summarized and compared.

Results: Two hundred infants were enrolled. SpO2 at each minute differed across groups (p < 0.01), with the lowest values in TGA. All interventions were most frequent in TGA (p < 0.01). Continuous positive airway pressure was provided in 22% SV-CAO, 23% CPO, and 66% TGA. Positive pressure ventilation occurred in 7% SV-CAO, 14% CPO, and 33% TGA. Intubation occurred in 4% SV-CAO, 10% CPO, and 53% TGA.

Conclusion: We defined SpO2 trajectories and delivery room respiratory interventions for three CCHD phenotypes. These results inform delivery room management of these high-risk populations.

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