脉搏血氧仪测量的出生时心率比心电图低。
Pulse oximetry measures a lower heart rate at birth compared with electrocardiography.
机构信息
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
The Ritchie Center, Monash Institute for Medical Research, Monash University, Melbourne, Australia.
出版信息
J Pediatr. 2015 Jan;166(1):49-53. doi: 10.1016/j.jpeds.2014.09.015. Epub 2014 Oct 14.
OBJECTIVE
To examine the effect of time after birth on heart rate (HR) measured by pulse oximetry (PO) (HRPO) and electrocardiography (ECG) (HRECG).
STUDY DESIGN
HRECG and HRPO (collected at maximum sensitivity) were assessed in 53 term and preterm infants at birth. ECG electrodes and a PO sensor were attached as soon as possible and HRECG and HRPO were compared every 30 seconds from 1-10 minutes after birth. Data were compared using a Wilkinson signed-rank test. Clinical relevance (eg, HR <100 beats per minute [bpm] was tested using a McNemar test).
RESULTS
Seven hundred fifty-five data pairs were analyzed. Median (IQR) gestational age was 37 (31-39) weeks. Mean (SD) starting time of PO and ECG data collection was 99 (33) vs 82 (26) seconds after birth (P = .001). In the first 2 minutes after birth, HRPO was significantly lower compared with HRECG (94 (67-144) vs 150 (91-153) bpm at 60 seconds (P < .05), 81 (60-109) vs 148 (83-170) bpm at 90 seconds (P < .001) and 83 (67-145) vs 158 (119-176) at 120 seconds (P < .001). A HR <100 bpm was more frequently observed with a PO than ECG in the first 2 minutes (64% vs 27% at 60 seconds (P = .05), 56% vs 26% at 90 seconds (P < .05) and 53% vs 21% at 120 seconds (P < .05). HR by ECG was verified by ultrasound for outflow from a subset of infants.
CONCLUSIONS
In infants at birth, HRPO is significantly lower compared with ECG with clinically important differences in the first minutes.
目的
研究通过脉搏血氧饱和度（PO）（HRPO）和心电图（ECG）（HRECG）测量出生后时间对心率（HR）的影响。
研究设计
在出生时评估了 53 名足月和早产儿的 HRECG 和 HRPO（在最大灵敏度下采集）。一旦可能，就会尽快附上 ECG 电极和 PO 传感器，并在出生后 1-10 分钟内每 30 秒比较一次 HRECG 和 HRPO。使用 Wilcoxon 符号秩检验比较数据。使用 McNemar 检验测试临床相关性（例如，HR <100 次/分钟）。
结果
分析了 755 对数据。中位（IQR）胎龄为 37（31-39）周。PO 和 ECG 数据采集的起始时间平均（SD）分别为 99（33）与 82（26）秒（P=.001）。出生后前 2 分钟，HRPO 明显低于 HRECG（60 秒时分别为 94（67-144）与 150（91-153）次/分钟（P <.05），90 秒时分别为 81（60-109）与 148（83-170）次/分钟（P <.001），120 秒时分别为 83（67-145）与 158（119-176）次/分钟（P <.001））。在前 2 分钟内，PO 比 ECG 更频繁地观察到 HR <100 bpm（60 秒时分别为 64%与 27%（P=.05），90 秒时分别为 56%与 26%（P <.05），120 秒时分别为 53%与 21%（P <.05））。对一部分婴儿进行了超声心动图验证，结果表明 ECG 测量的 HR 是正确的。
结论
在出生时的婴儿中，HRPO 明显低于 ECG，在前几分钟内存在重要的临床差异。
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