Objective: To characterize pulse oxygen saturation (SpO) 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 SpO values and respiratory interventions were summarized and compared.

Results: Two hundred infants were enrolled. SpO 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 SpO 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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http://dx.doi.org/10.1038/s41372-021-01029-2DOI Listing

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