Related Experiment Video
Updated: Sep 4, 2025
A Swine Model of Neonatal Asphyxia
Published on: October 11, 2011
Frequent hypoxemia found in infants with bronchopulmonary dysplasia after weaning home oxygen
Melissa House1,2, Sarah Klein3, Danielle Parham1,2
1Division of Neonatology and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Nocturnal oximetry identified previously undetected hypoxemia in most infants with bronchopulmonary dysplasia (BPD) ready for oxygen weaning. This home monitoring tool can reveal hidden hypoxemia in BPD patients.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Infants with bronchopulmonary dysplasia (BPD) often require supplemental oxygen.
- Weaning infants off oxygen typically relies on parental reports and clinical exams.
- The utility of nocturnal oximetry in detecting unapparent hypoxemia at home is not well-established.
Purpose of the Study:
- To determine if nocturnal oximetry can identify unreported hypoxemia in infants with BPD.
- To assess the feasibility and usefulness of home oximetry for evaluating hypoxemia in this population.
Main Methods:
- Retrospective chart review of infants born <32 weeks gestation with BPD.
- Analysis of recorded nocturnal oximetry data in room air.
- Definition of abnormal oximetry: >5 minutes with SpO2 <90% and/or an oxyhemoglobin desaturation index (ODI4) >5.
Main Results:
- Nocturnal oximetry was abnormal in 67% of the 35 infants studied.
- Hypoxemia or frequent desaturations were observed in the majority of infants.
- No significant differences in neonatal characteristics were found between normal and abnormal oximetry groups.
Conclusions:
- Nocturnal oximetry identified significant hypoxemia in most infants with BPD ready for oxygen weaning.
- Home oximetry appears to be a feasible and valuable tool for detecting clinically unapparent nocturnal hypoxemia.
- This method can aid in managing oxygen therapy for infants with BPD.
Objective:
Parental reports and brief clinical examinations are the primary information used to assist clinicians in weaning home supplemental oxygen in infants with bronchopulmonary dysplasia (BPD). Recorded nocturnal oximetry provides an objective assessment of hypoxemia; however, it is unknown if it identifies clinically undetected hypoxemia in the home setting. Our objective was to determine if nocturnal oximetry can identify unreported hypoxemia in infants with BPD who appear ready to wean from supplemental oxygen.
Study Design:
We conducted a retrospective chart review of infants born <32 weeks gestation with BPD who were discharged to home receiving supplemental oxygen and completed recorded nocturnal oximetry in room air during an 18-month period. Abnormal oximetry was defined as >5 min with SpO2 < 90% and/or an oxyhemoglobin desaturation index (ODI4) >5. Comparative analysis of patients with normal and abnormal overnight oximetry was performed using Fisher Exact and Wilcoxon signed-rank test.
Results:
Thirty-five former premature infants completed nocturnal oximetry at 5.8 (3.4-8.3) months corrected age. Nocturnal oximetry was abnormal as defined in 67% of the cohort (n = 21). Five percent of patients were hypoxemic, 52% had frequent desaturation events, and 43% had both. No significant differences existed in neonatal characteristics between patients with normal and abnormal studies.
Conclusions:
Nocturnal oximetry was abnormal in the majority of infants with BPD who were otherwise clinically ready to wean from oxygen support, suggesting that recorded home oximetry could be a feasible and useful tool to evaluate for otherwise clinically unapparent nocturnal hypoxemia in patients with BPD.
Related Concept Videos
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
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...
01:17Pulmonary Cycle: Exhalation
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,...
01:23Acute Respiratory Failure-IV
01:23Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...