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Arterial oxygen saturation in preterm infants at discharge from the hospital and six weeks later
C F Poets1, V A Stebbens, J R Alexander
1National Heart and Lung Institute, Brompton Hospital, London, England, United Kingdom.
Insights
Arterial oxygen saturation (SaO2) in preterm infants improves significantly after discharge, with fewer desaturation episodes. Follow-up data shows preterm infants normalize oxygenation, matching term infants by corrected age.
Area of Science:
- Neonatal Physiology
- Respiratory Medicine
- Pediatric Pulmonology
Background:
- Preterm infants often experience variations in arterial oxygen saturation (SaO2).
- Understanding normal SaO2 ranges and developmental changes is crucial for preterm infant care.
- Early identification of hypoxemia in preterm infants is essential for optimal outcomes.
Purpose of the Study:
- To establish normal arterial oxygen saturation (SaO2) data in preterm infants.
- To investigate early developmental changes in SaO2 and desaturation episodes.
- To compare SaO2 parameters between preterm and term infants at corrected gestational age.
Main Methods:
- Overnight tape recordings of SaO2 and breathing movements were obtained in 160 preterm infants at discharge.
- A subset of 110 infants underwent a second recording 6 weeks later.
- Recordings were compared between preterm infants and 67 term infants at corrected gestational age.
Main Results:
- Median baseline SaO2 increased significantly from 99.5% at discharge to 100% at follow-up.
- The number of desaturation episodes (SaO2 ≤ 80% for ≥ 4 seconds) decreased significantly from a median of 3 to 0.
- At corrected gestational age, preterm infants exhibited similar SaO2 and desaturation rates compared to term infants.
Conclusions:
- Preterm infants show significant improvements in SaO2 and reduced desaturation episodes post-discharge.
- Normal ranges of oxygenation and their age-related changes are valuable for detecting undetected hypoxemia.
- Further research is needed to determine the clinical impact of early hypoxemia on preterm infant outcomes.
Abstract:
To obtain normal data on arterial oxygen saturation (SaO2) in preterm infants and to study early developmental changes in SaO2, we obtained overnight tape recordings of SaO2 and breathing movements in 160 preterm infants at their discharge from three special care baby units (mean gestational age at birth 33 weeks; at time of study, 37 weeks). One hundred ten infants (69%) underwent a second recording 6 weeks later. Median baseline SaO2 during regular breathing was 99.5% (range 88.7% to 100%) at discharge, and 100% (range 95.3% to 100%) at follow-up (p less than 0.001). The number of episodes of desaturation, defined as a fall in SaO2 to less than or equal to 80% for at least 4 seconds, corrected to the mean duration of recording (12.2 hours), decreased from a median of 3 (0 to 355) to 0 (0 to 17) (p less than 0.001). The median duration of each episode of desaturation remained unchanged (5.2 (4.0 to 22.7) vs 5.5 (4.2 to 24.0) seconds). At discharge, a small minority of infants had a clinically unrecognized low baseline SaO2 (lowest, 88.7%; 5th percentile, 95.7%) or a high number of desaturation episodes (the highest was six times the 95th percentile value). At follow-up, all outlying values had normalized. Follow-up recordings made between 42 and 47 weeks of gestational age (n = 53) were compared with similar recordings from 67 term infants at the same gestational age. The preterm infants had a significantly higher baseline SaO2 and no more desaturation than the infants born at term. Knowledge of normal ranges of oxygenation and their changes with age may be of value in identifying clinically undetected hypoxemia in preterm infants at discharge from the hospital. The potential influence of such hypoxemia on clinical outcome remains to be determined.