Use of a Combined SpO(2)/PtcCO(2) Sensor in the Delivery Room.

Abstract: Arterial oxygen saturation (SaO2) and partial arterial pressure of carbon dioxide
(PaCO2) are important respiratory parameters in critically ill neonates. A sensor combining
a pulse oximeter with the Stow-Severinghaus electrode, required for the measurement
of peripheral oxygen saturation (SpO2) and transcutaneous partial pressure of carbon
dioxide (PtcCO2), respectively, has been recently used in neonatal clinical practice
(TOSCA500®Radiometer). We evaluated TOSCA usability and reliability in the delivery
room (DR), throughout three different periods, on term, late-preterm, and preterm
neonates. During the first period (period A), 30 healthy term neonates were simultaneously
monitored with both TOSCA and a MASIMO pulse oximeter. During the second period
(period B), 10 healthy late-preterm neonates were monitored with both TOSCA and a
transcutaneous device measuring PtcCO2 (TINA® TCM3, Radiometer). During the third
period (period C), 15 preterm neonates were monitored with TOSCA and MASIMO after
birth, during stabilization, and during transport to the neonatal intensive care unit (NICU).
Blood gas analyses were performed to compare transcutaneous and blood gas values.
TOSCA resulted easily and safely usable in the DR, allowing reliable noninvasive SaO2
estimation. Since PtcCO2 measurements with TOSCA required at least 10 min to be stable
and reliable, this parameter was not useful during the early resuscitation immediately
after birth. Moreover, PtcCO2 levels were less precise if compared to the conventional
transcutaneous monitoring. However, PtcCO2 measurement by TOSCA was useful as
trend-monitoring after stabilization and during transport to NICU.