Related Experiment Video
Updated: Mar 8, 2026
Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Evidence to Support Oxygen Guidelines for Children with Emergency Signs in Developing Countries: A Systematic Review
1Centre for International Child Health, University of Melbourne, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
Insights
For children with life-threatening conditions, a 90% oxygen saturation threshold is recommended for initiating oxygen therapy, except during resuscitation where 94% may be beneficial. This approach ensures adequate oxygen delivery and conserves resources.
Area of Science:
- Pediatric Emergency Medicine
- Critical Care
- Respiratory Physiology
Background:
- Current guidelines lack evidence-based oxygen saturation targets for critically ill children.
- WHO Emergency Triage Assessment and Treatment (ETAT) guidelines identify children with emergency signs requiring oxygen therapy.
- Establishing safe and effective oxygen saturation (SpO2) targets is crucial for pediatric critical care.
Purpose of the Study:
- To review existing evidence and inform safe SpO2 targets for oxygen therapy in children with emergency signs.
- To provide evidence-based recommendations for SpO2 thresholds in pediatric emergency care.
- To optimize oxygen delivery while considering resource limitations.
Main Methods:
- Systematic review of physiological data and international guidelines.
- Analysis of evidence related to SpO2 targets for oxygen therapy in children.
- Evaluation of WHO ETAT guidelines for emergency signs in children.
Main Results:
- A threshold SpO2 of 90% is suggested for initiating oxygen in children with acute lung disease not requiring resuscitation.
- An SpO2 target of ≥94% during resuscitation may be beneficial in resource-limited settings.
- A lower limit of 90% SpO2 for commencing oxygen in stable children post-resuscitation with lung disease ensures adequate delivery and resource conservation.
Conclusions:
- A 90% SpO2 threshold is adequate for initiating oxygen in non-resuscitated children with acute lung disease.
- Higher SpO2 targets (≥94%) during resuscitation may be necessary in certain contexts.
- Evidence-based SpO2 targets can improve pediatric emergency care and resource utilization.
Abstract:
There are currently no evidence-based oxygen saturation targets for treating children with life-threatening conditions. We reviewed evidence of SpO2 targets for oxygen therapy in children with emergency signs as per WHO Emergency Triage Assessment and Treatment guidelines. We systematically searched for physiological data and international guidelines that would inform a safe approach. Our findings suggest that in children with acute lung disease who do not require resuscitation, a threshold SpO2 for commencing oxygen of 90% will provide adequate oxygen delivery. Although there is no empirical evidence regarding oxygen saturation to target in children with emergency signs from developing countries, a SpO2 of ≥ 94% during resuscitation may help compensate for common situations of reduced oxygen delivery. In children who do not require resuscitation or are stable post resuscitation with only lung disease, a lower limit of SpO2 for commencing oxygen of 90% will provide adequate oxygen delivery and save resources.
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
01:19Guidelines For Measuring Vital Signs
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:29Oxygen Requirements and Growth Patterns