Use of Low-Flow Flowmeter to Titrate the FiO 2 Delivered in Neonatal Resuscitation

Abstract

Introduction:

The oxygen concentration used in neonatal resuscitation has been a matter of debate with higher oxygen concentrations posing many adverse outcomes. Recent guidelines recommend use of blender to titrate FiO₂ delivered during resuscitation. However, blender being unaffordable and unavailable at many peripheral institutions, we tried to use a low-flow flowmeter to titrate the oxygen and measure FiO₂ delivered at different flow rates.

Methods:

From a central oxygen supply, oxygen flow was titrated using a low-flow flowmeter which was connected to a self-inflating bag and oximeter. Three variables were taken—volume of self-inflating bag, flow rate, and number of compressions per minute. FiO₂ delivered with each variable, keeping the other two constant, was recorded.

Results:

The data obtained was analyzed by fitting the study variables into a stepwise multiple linear regression model and a linear equation was obtained. The model R square obtained suggested strong linear relationship between flow rate and FiO₂ delivered. The model showed statistically significant association between flow rate and FiO₂ delivery, whereas association with other variables was statistically insignificant. Discussion: Our study suggests that 76.57% of change in FiO₂ is determined by change in flow rate. The major advantage of this study would be at resource poor settings where a low-flow flowmeter which is more cost effective can be used to titrate the FiO₂ delivered during neonatal resuscitation.