Helman Justin, Bawa Mausma, Gugino Sylvia, Bradley Nicole, Nielsen Lori, Prasath Arun, Blanco Clariss, Kasu Mary Divya, Abbasi Hamza, Rawat Munmun, Chandrasekharan Praveen
Division of Neonatology, Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA.
Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Children (Basel). 2025 Sep 10;12(9):1205. doi: 10.3390/children12091205.
Expert guidelines recommend using pulse oximetry (PO) in the delivery room to monitor oxygen saturation (SpO) and heart rate (HR). Umbilical cord pulse oximetry (UCP) is a novel concept that, despite being postductal, could provide accurate measurements of SpO and HR, as it overcomes barriers associated with skin pigmentation.
This pilot study used NONIN pulse oximetry on an intact umbilical cord that underwent deferred cord clamping (DCC) to evaluate umbilical cord SpO in a preterm asphyxiated ovine model (N of 5) with an HR of <100 bpm. The UCP HR served as a surrogate marker for umbilical vessel flow. A receiver operator characteristic (ROC) curve was used to evaluate UCP parameters with arterial saturations (SaO) and carotid HR between 2 and 10 min.
Following asphyxia, five preterm lambs underwent DCC for 4 min. A significant relationship was noted between SaO and umbilical SpO (area under the curve (AUC) of 0.907, CI 0.857-0.968, < 0.0001) along with carotid and umbilical HR (AUC) of 0.842 (CI 0.663-0.902, < 0.0001).
In a translational preterm model, UCP accurately predicted preductal SaO and carotid HR (a surrogate for umbilical flow). Using UCP in the delivery room will help guide supplemental oxygen and determine the optimal duration of clamping the umbilical cord. These proof-of-concept studies/pilot findings require validation with larger animal cohorts and newborn infants.
专家指南建议在产房使用脉搏血氧饱和度仪（PO）来监测血氧饱和度（SpO）和心率（HR）。脐带脉搏血氧饱和度仪（UCP）是一个新概念，尽管它是测量导管后情况，但由于它克服了与皮肤色素沉着相关的障碍，因此可以准确测量SpO和HR。
本前瞻性研究在完整的脐带上使用NONIN脉搏血氧饱和度仪，对接受延迟脐带结扎（DCC）的早产窒息羊模型（n = 5）进行评估，这些羊的HR<100次/分钟。UCP HR作为脐血管血流的替代指标。使用受试者工作特征（ROC）曲线评估2至10分钟内UCP参数与动脉血氧饱和度（SaO）和颈动脉HR之间的关系。
窒息后，5只早产羔羊接受了4分钟的DCC。观察到SaO与脐SpO之间存在显著相关性（曲线下面积（AUC）为0.907，CI为0.857 - 0.968，P<0.0001），以及颈动脉和脐HR之间的相关性（AUC）为0.842（CI为0.663 - 0.902，P<0.0001）。
在一个转化性早产模型中，UCP准确预测了导管前SaO和颈动脉HR（脐血流的替代指标）。在产房使用UCP将有助于指导补充氧气并确定脐带结扎的最佳持续时间。这些概念验证研究/前瞻性研究结果需要在更大的动物队列和新生儿中进行验证。
