Inadvertent hyperoxia during intraoperative care in neonates: a case-series study

While oxygen administration has been in clinical practice, the focus has generally been on avoidance of hypoxemia. More recently, renewed emphasis has been placed on the potential deleterious effects of hyperoxia. The aim of this study is to investigate the incidence of intraoperative inadvertent hyperoxia among neonate, which was defined at three different thresholds: normoxia (PaO₂ 60-100 mmHg), hyperoxia (PaO₂ 101-199 mmHg), and severe hyperoxia (PaO₂ ≥ 200 mmHg). This study included 65 patients with 174 eligible arterial blood gas (ABG) samples, who were less than 60 weeks post-menstrual age and required a non-cardiac surgical procedure. Among the 65 patients, 62 (96%) patients experienced either hyperoxia or severe hyperoxia during general anesthesia on at least one ABG. Among the 174 ABG readings, only 28 (16%) had PaO₂ levels within our defined normoxia range. The incidence of hyperoxia in neonate under general anesthesia is high. Although it is unknown if brief exposure during anesthesia is associated with similar outcomes, educational initiatives seem warranted to increase awareness of these clinical concerns, as there seems to be limited clinical benefit from such care.