Delivery room oxygen physiology and respiratory interventions for newborns with cyanotic congenital heart disease

Objective To characterize pulse oxygen saturation (SpO 2 ) trajectories and respiratory interventions after birth for newborns with cyanotic congenital heart disease (CCHD). Study design Retrospective single-site study of newborns ≥32 weeks gestation with CCHD: single ventricle with critical aortic obstruction (SV-CAO), critical pulmonic obstruction (CPO), transposition of the great arteries (TGA). Minute-to-minute SpO 2 values and respiratory interventions were summarized and compared. Results Two hundred infants were enrolled. SpO 2 at each minute differed across groups ( p < 0.01), with the lowest values in TGA. All interventions were most frequent in TGA ( p < 0.01). Continuous positive airway pressure was provided in 22% SV-CAO, 23% CPO, and 66% TGA. Positive pressure ventilation occurred in 7% SV-CAO, 14% CPO, and 33% TGA. Intubation occurred in 4% SV-CAO, 10% CPO, and 53% TGA. Conclusion We defined SpO 2 trajectories and delivery room respiratory interventions for three CCHD phenotypes. These results inform delivery room management of these high-risk populations.