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Cardiorespiratory Transitioning at Birth during Varying Levels of Resuscitation and the Role of Dry-Electrode ECG (NeoBeat) and Pulse Oximetry in a Low Resource Setting

Year: 2026

Type: article

Abstract: INTRODUCTION: Studies on neonatal cardiorespiratory transition are important in guiding resuscitation guidelines. The objectives were to determine the immediate transitional changes of heart rate (HR) and saturation values in neonates who received various levels of resuscitation and the level of agreement between NeoBeat and pulse oximetry. METHODS: High-risk deliveries (n = 63) in a low resource setting were observed using pulse oximetry and NeoBeat in three groups: comfortably breathing receiving no resuscitation, labored breathing receiving oxygen only, and apneic receiving bag mask ventilation (BMV) plus oxygen. Data were analyzed by time of birth and compared for levels of agreement. RESULTS: Comfortably breathing neonates had initial saturation values (86 ± 13%) with relatively high initial HRs (177 ± 19 beats per minute [bpm]). For neonates receiving oxygen only, 43% reached target saturation goals despite an initial HR of 150 ± 21 bpm, while the BMV group had 73% reach target saturation goals with an initial HR of 88 ± 40 bpm. Bland-Altman revealed low bias in all groups and progressively wider lines of agreement as neonates required more resuscitation. In the BMV group, pulse oximetry often displayed a lower HR than NeoBeat at lower mean HR values. CONCLUSIONS: Elevated early saturation values and higher HRs in comfortably breathing neonates may be indicative of a seamless cardiorespiratory adaptation. For neonates requiring resuscitation, oxygen alone without positive end-expiratory pressure may delay respiratory transitioning, as evidenced by low oxygen saturations at 5 min, whereas a higher percentage of neonates receiving BMV with oxygen met target saturation goals.

Source: Neonatology

DOI: 10.1159/000552554

Authors: Emily Ahn, Jackline Cypriane, Ester Ngowi, Aisa Shayo, Jeffrey Perlman

Institutions: Weill Cornell Medicine, Weill Cornell Medical Center, Kilimanjaro Christian Medical Centre, KCMC University

Language: English

Topic: Neonatal Respiratory Health Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: Bloomberg Philanthropies, National Institutes of Health