Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

To determine if a change in the pulse oximeter goal range and high alarm limit for oxygen saturation (SpO2) alters the distribution of SpO2 for premature infants in oxygen.

This was a prospective, observational analysis. For group 1 (February 2002 to April 2002, n = 23), pulse oximeter alarms were set at 80% (low) and 96% (high), and the goal range was 90-95%. For group 2 (May 2002 to August 2003, n = 49), the high alarm was lowered to 94%, and the goal range was 88 to 94%. The SpO2 values for 24 h were downloaded from Nellcor pulse oximeters during the two periods and the percent time within, above and below the goal range was derived and compared.

Groups were similar except for use of post-natal steroids (group 2 > 1). The percent time within (57.7+/-9.8 vs 59.4+/-12.4%), above (15.4+/-10.6 vs 14+/-9.4%) and below (26.9+/-9.7 vs 26.6+/-10.2%) the goal range was similar for groups 1 and 2, respectively. However, the percent time with SpO2 <80% increased significantly for group 2 (4.0+/-2.7 vs 1.9+/-1.4%).

Changes in pulse oximeter policy and alarms in labile, sick premature infants need evaluation for their effects on the distribution of SpO2 values before routine use.