The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

DOES UMBILICAL CORD pH CORROLATE WITH LEVEL III NICU ADMISSION? Richard M. Hoskins RRT C-CPT CPFT

Presbyterian Hospital of Plano. Plano, Texas Data collection was performed at Christus St Joseph Hospital NICU, Houston Texas

Background: The 45 bed Level III NICU serves a large cross section of the urban population. The NICU Team (MD, RN, RT) responds to all high-risk and c-section deliveries. The question had been raised whether Umbilical Cord pH would be a valid indicator of newborn acuity. A retrospective study was employed to determine if a low Umbilical Cord pH was correlated with NICU admission. Our criteria for fetal hypoxia, per ACOG guidelines, was a Cord pH of < 7.20. Several more recent papers have called for a Cord pH of < 7.0 as a more accurate predictor of fetal hypoxia.

Study Question: Can Umbilical Cord Blood pH analysis be of significant value in the NICU admission criteria for the Neonatal Population?

Methods: Retrospective data collection of all live births in our facility in an 18 month period. We found a 99.89% collection rate for all live births; the missing Cord pH analysis was (1) no blood collected per OB/GYN preference (2) no sample due to collection errors (3) lost sample or improper collection of sample; in order of incidence.

Data: 9.2% of all live birth deliveries had a Cord pH of < 7.20 (617 of 6386 live births)

During this period, the NICU team (Neonatologist, NICU RN & NICU RT) attended 2601 deliveries due to some risk factor (multiple births, C-Sections, abnormal FHR, prematurity, request of attending OB/GYN).

Of these attended deliveries, only 312 (12%) had a Cord pH of < 7.20, 17 (0.65%) < 7.0.

Of all admissions to the NICU, 12.8% had a cord pH of < 7.20

Of all deliveries, 0.33% had a Cord pH of < 7.0

Of all admissions to the NICU, (including referrals) 1.98% had a Cord pH of < 7.0.

Analysis: Less than 10% of all live births had a cord pH of < 7.20, and only 12.8% of all admissions (including referrals) had an associated Cord pH of < 7.20.

Less than 1% of all live births had a Cord pH of < 7.0, and only 0.004% of all deliveries, associated with a Cord pH of < 7.0, required admission to the NICU.

Conclusion: In our facility, low Umbilical Cord pH was not a valid indicator of fetal hypoxia, nor a predictor for NICU admission.

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