Background CO2 is not routinely measured in the delivery suite during neonatal resuscitation.
Objectives To determine
Is capnography feasible in the delivery suite for preterm infants (<32 weeks)?
Does capnography use in the delivery suite enhance neonatal adaptation as determined by incidence of normocarbia following neonatal unit admission?
Methods 2 groups of infants were included. The first cohort did not have capnography used during their care in the delivery suite and were part of a study assessing blood sampling in preterm infants (Nov 12 – April 2013). The second group of infants had capnography performed in the delivery suite. A blood gas analysis reading of 5–8 Kpa was deemed to be within a normal range and was the determinant of a positive outcome. Ethics approval was granted and parental consent was obtained in all. Physicians were not instructed to achieve any particular EtCO2 reading whilst in the delivery room.
Results 83 infants were included in this study, 48 in the first cohort and 35 in the capnography cohort. Capnography was used in all infants in the prospective cohort. There was no difference in mean gestational age between the groups (28.4 ± 3.1 weeks versus 28.7 ± 1.8 weeks). The percentage of normocarbia was 47.9%(n = 23) in the first cohort compared to 51.4% (n = 18) in the second cohort (p-value 0.52). There was no difference in the incidence of hypocarbia between the groups (8.8% vs. 8.5%).
Discussion Our results have shown that it is feasible to use capnography in the delivery suite. Capnography appears safe and was not associated with an increased incidence of hypocarbia. Randomised controlled trials with pre-determined acceptable EtCO2 levels are needed to determine whether capnography for PPV is associated with improved neonatal outcomes.