Related Experiment Video
Updated: Jun 18, 2026
Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Systematic underestimation of oxygen delivery in ventilated preterm infants
Claudio De Felice1, Stefano Bechelli, Gabriele Tonni
1Neonatal Intensive Care Unit, Policlinico S. Maria alle Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy. claudiodefelix @ hotmail.it
Background:
Emerging evidence indicates that hyperoxia is a risk factor for bronchopulmonary dysplasia, a common multifactorial long-term complication of prematurity. To date, the equivalence between set and delivered oxygen (O(2)) in ventilated preterm infants has not been rigorously studied.
Objectives:
To test the hypothesis of systematic underestimation of O(2) delivery in extremely low birth weight (ELBW) infants during long-term ventilation.
Methods:
Actually achieved O(2) concentrations were measured and compared to the set inspired oxygen fraction (FiO(2)). A total of 108 O(2) measurements were carried out during the ventilation of 54 ELBW infants: O(2)-Delta error (i.e., the difference between O(2) concentrations achieved by the ventilator and set FiO(2)) was the main study outcome measure.
Results:
Systematic O(2)-Delta errors were found, with mean values of +9.52% (FiO(2) 0.21-0.40), +2.10 (FiO(2) 0.41-0.60), +2.86% (FiO(2) 0.61-0.80), and +0.016% (FiO(2) 0.81-1.0; p < 0.0001). Theoretical simulations from the observed data indicate that, if not corrected, systematic O2-Delta errors would lead to a non-intentional total O(2) load of 1,202.9 (FiO(2) 0.21-0.40), 252.46 (FiO(2) 0.41-0.60), 342.85 (FiO(2) 0.61-0.80), and 2 (FiO(2) 0.81-1.0) extra liters/kg body weight/100 ventilation hours.
Conclusions:
Systematic underestimation of the O(2) delivered by infant ventilators can potentially lead to surprisingly large increases in total O(2) load during long-term ventilation of ELBW infants, especially in the lower FiO(2) range (i.e., 0.21-0.40). Underestimation of true O(2) delivery can potentially lead to unrecognized high O(2) loads, and more pronounced and prolonged hyperoxia.
Related Concept Videos
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is important.
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...