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