Background The European Resuscitation Council (ERC) guidelines prescribe oxygen saturation (SpO₂) targets for the first 10 minutes of resuscitation after birth. Unfortunately, the control of SpO₂ in newborn infants is difficult.

Objectives To determine whether a device that displays trend lines, reduced deviation from SpO₂ targets during resuscitation of very preterm infants after birth.

Methods In a single-centre study, deviation from the SpO₂ targets during resuscitation of preterm infants (gestational age (GA) ≤30 weeks) with the aid of a newly developed graphical interface, displaying the trends of SpO₂, fraction of inspired oxygen (FiO₂), was compared with current clinical practice. Data presented as median (IQR).

Results Ten infants (GA 27⁴/₇ (25–28³/₇) weeks, birth weight (BW) 812g (694–1068g)) were resuscitated using the graphical interface and 42 infants (GA 27⁵/₇ (25⁶/₇–29¹/₇) weeks, BW 930g (760–1148g)) were included in the control group. We found that infants resuscitated with the graphical interface spend less time above the SpO₂ targets (18% (4–24%) vs. 26% (13–42%)), and had a smaller deviation during the time spend above the SpO₂ targets (2.3%SpO₂ (1.2–3.8%SpO₂) vs. 3.8%SpO₂ (2.5–6.3%SpO₂)). Both time spend below the SpO₂ targets (29% (21–39%) vs. 24% (14–34%)), and deviation below the target (10.5%SpO₂ (8.3–25.9%SpO₂) vs. 7.1%SpO₂ (1.9–11.7%SpO₂)) increased.

Conclusion The use of a graphical interface decreased high SpO₂ levels during the resuscitation of preterm infants. However, both time spend and deviation below the SpO₂ targets increased. It appears the current ERC guidelines are interpreted as the maximum acceptable SpO₂, a target range would clarify the acceptable deviation.