Swamy Suvvi K Narayana, Stockwell Simon J, Liu Chong, Henry Caroline, Shipley Lara, Ward Carole, Mirahmadi Siavash, Correia Ricardo, Morgan Stephen P, Crowe John A, Sharkey Don, Hayes-Gill Barrie R
Optics and Photonics Research Group and Centre for Healthcare Technologies, University of Nottingham, University Park, Nottingham, UK.
Centre for Perinatal Research, School of Medicine, University of Nottingham, Nottingham, UK.
Pediatr Res. 2024 Oct 17. doi: 10.1038/s41390-024-03651-0.
To study the feasibility of measuring heart rate (HR) and oxygen saturation (SpO) on the forehead, during newborn transition at birth, and to compare these measurements with those obtained from the wrist.
Vital signs were measured and compared between forehead-mounted reflectance (remittance) photoplethysmography sensor (fhPPG) and a wrist-mounted pulse oximeter sensor (wrPO), from 20 enrolled term newborns born via elective caesarean section, during the first 10 min of life.
From the datasets available (n = 13), the median (IQR) sensor placement times for fhPPG, ECG and wrPO were 129 (70) s, 143 (68) s, and 159 (76) s, respectively, with data recorded for up to 10 min after birth. The success rate (percentage of total possible HR values reported once sited) of fhPPG (median = 100%) was higher compared to wrPO (median = 69%) during the first 6 min of life (P < 0.005). Both devices exhibited good HR agreement with ECG, achieving >95% agreement by 3 (fhPPG) and 4 (wrPO) min. SpO for fhPPG correlated with wrPO (r = 0.88), but there were significant differences in SpO between the two devices between 3 and 8 min (P < 0.005), with less variance observed with fhPPG SpO.
In the period of newborn transition at birth in healthy term infants, forehead measurement of vital signs was feasible and exhibited greater HR accuracy and higher estimated SpO values compared to wrist-sited pulse oximetry. Further investigation of forehead monitoring based on the potential benefits over peripheral monitoring is warranted.
This study demonstrates the feasibility of continuously monitoring heart rate and oxygen saturation from an infant's forehead in the delivery room immediately after birth. Significantly higher SpO measurements were observed from the forehead than the wrist during the transition from foetal to newborn life. Continuous monitoring of vital signs from the forehead could become a valuable tool to improve the delivery of optimal care provided for newborns at birth.
研究在新生儿出生过渡期间测量前额心率（HR）和血氧饱和度（SpO）的可行性，并将这些测量结果与从手腕获得的测量结果进行比较。
对20例择期剖宫产出生的足月儿，在出生后的前10分钟内，使用前额反射式（透射式）光电容积脉搏波传感器（fhPPG）和手腕式脉搏血氧饱和度传感器（wrPO）测量并比较生命体征。
从可用数据集中（n = 13），fhPPG、心电图（ECG）和wrPO的传感器放置中位时间（四分位间距）分别为129（70）秒、143（68）秒和159（76）秒，出生后记录数据长达10分钟。在出生后的前6分钟内，fhPPG的成功率（放置后报告的总可能HR值的百分比，中位值 = 100%）高于wrPO（中位值 = 69%）（P < 0.005）。两种设备与ECG的HR一致性均良好，fhPPG在3分钟时、wrPO在4分钟时达到>95%的一致性。fhPPG的SpO与wrPO相关（r = 0.88），但在3至8分钟内两种设备的SpO存在显著差异（P < 0.005），fhPPG的SpO方差较小。
在健康足月儿出生过渡期间，前额测量生命体征是可行的，与手腕式脉搏血氧饱和度测量相比，HR准确性更高，SpO估计值更高。基于与外周监测相比的潜在益处，有必要进一步研究前额监测。
本研究证明了在出生后立即在产房从婴儿前额连续监测心率和血氧饱和度的可行性。在从胎儿到新生儿的过渡期间，观察到前额的SpO测量值明显高于手腕。从前额连续监测生命体征可能成为改善出生时为新生儿提供最佳护理的有价值工具。
