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Hyperoxemia in newborn infants: detection by pulse oximetry
H U Bucher1, S Fanconi, P Baeckert
1Department of Obstetrics and Gynecology, University of Zurich, Switzerland.
Pediatrics
|August 1, 1989
Summary
Pulse oximetry can reliably detect hyperoxemia in newborns if alarm limits are adjusted for specific devices. This study evaluated two pulse oximeters, finding that tailored settings improve accuracy in monitoring oxygen saturation.
Area of Science:
- Neonatal Medicine
- Biomedical Engineering
- Respiratory Physiology
Background:
- Pulse oximetry offers noninvasive, continuous monitoring of transcutaneous oxygen saturation (tcSO2) in neonates.
- Its reliability in detecting hyperoxemia (PaO2 > 90 mm Hg) is debated due to saturation changes above 90% correlating with large PaO2 shifts.
Purpose of the Study:
- To evaluate pulse oximetry's accuracy in detecting neonatal hyperoxemia using a 95% tcSO2 alarm limit.
- To assess how adjusting alarm limits impacts the reliability of hyperoxemia detection.
Main Methods:
- Two pulse oximeters (Nellcor N-100, Ohmeda Biox 3700) were tested in 50 mechanically ventilated infants.
- Simultaneous tcSO2 and arterial PaO2 measurements were taken during oxygen level adjustments.
Main Results:
- Nellcor N-100 showed 100% sensitivity and 49% specificity for hyperoxemia.
- Ohmeda Biox 3700 demonstrated 37% sensitivity and 83% specificity.
- Optimal alarm limits varied: Nellcor at 96% tcSO2 (38% specificity), Ohmeda at 89% tcSO2 (52% specificity).
Conclusions:
- Pulse oximeters can be sensitive for detecting hyperoxemia in neonates.
- Accurate detection requires device-specific alarm limits.
- Accepting lower specificity is necessary to achieve high sensitivity for hyperoxemia detection.