Abstract
Monitoring of preterm infants in the delivery room (DR) remains limited. Current guidelines suggest that pulse oximetry should be available for all preterm infant deliveries, and that if intubated a colorimetric carbon dioxide detector should provide verification of correct endotracheal tube placement. These two methods of assessment represent the extent of objective monitoring of the newborn commonly performed in the DR. Monitoring non-invasive ventilation effectiveness (either by capnography or respiratory function monitoring) and cerebral oxygenation (near-infrared spectroscopy) is becoming more common within research settings. In this article, we will review the different modalities available for cardiorespiratory and neuromonitoring in the DR and assess the current evidence base on their feasibility, strengths, and limitations during preterm stabilization.
Highlights
We have witnessed a significant increase in the number of monitoring options for preterm infants in the neonatal intensive care unit (NICU) setting
As adjuncts to clinical monitoring during initial preterm stabilization in the delivery room (DR), the recent 2015 ILCOR recommendations advise the use of two objective assessment tools: [1] pulse oximetry to regulate oxygen delivery and [2] exhaled carbon dioxide (CO2) detectors for confirmation of correct endotracheal (ET) tube placement [1]
Preterm infant monitoring during DR stabilization remains relatively basic when compared to the enhanced monitoring available in the NICU
Summary
Current ILCOR Guidelines recommend for all preterm infant deliveries:. Pulse oximetry for SpO2 monitoring and titration of O2 therapy Pulse oximetry and consideration of ECG as an adjunct for heart rate monitoring CO2 detectors to verify correct endotracheal tube positioning.
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