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Pulse oximetry advantages in infants with bronchopulmonary dysplasia
Insights
Pulse oximetry is more accurate than transcutaneous PO2 monitoring for infants with bronchopulmonary dysplasia. This study found pulse oximeters offer significant advantages for managing these oxygen-dependent neonates.
Area of Science:
- Neonatal Medicine
- Respiratory Physiology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in infants.
- Oxygen dependency is common in infants diagnosed with BPD.
Purpose of the Study:
- To compare the accuracy of pulse oximetry and transcutaneous PO2 monitoring.
- To evaluate their utility in managing oxygenation in infants with BPD.
Main Methods:
- Simultaneous measurements of hemoglobin oxygen saturation (SaO2) and transcutaneous PO2 (tcPO2) were taken.
- Data were correlated with arterial oxygen saturation (SaO2) and partial pressure of oxygen (PaO2) from arterial blood gas analysis.
- Fractional inspiratory oxygen (FiO2) was adjusted to achieve SaO2 levels between 70% and 95%.
Main Results:
- Pulse oximeters (Nellcor 100, BTI Biox III) showed good correlation with arterial SaO2 (slopes of 0.86 and 0.91).
- Transcutaneous PO2 (Sensor Medics Transend) demonstrated poor correlation (slope of 0.55) and significant error (-29%).
- No infants experienced hyperoxia when SaO2 was ≤95%.
Conclusions:
- Pulse oximetry is a more reliable method for assessing oxygenation in infants with BPD compared to tcPO2.
- Pulse oximetry offers advantages due to ease of use and safety (no burns).
- Noninvasive pulse oximetry is recommended for managing oxygenation in BPD infants.
Abstract:
We studied 12 infants with a clinical and radiologic diagnosis of bronchopulmonary dysplasia who were oxygen dependent and older than 30 days. Simultaneous readings of hemoglobin oxygen saturation (SaO2) determined by two pulse oximeters (Nellcor 100, BTI Biox III) and transcutaneous (tc) PO2 (Sensor Medics, Transend) were correlated with SaO2 (Radiometer, OSM 2 Hemoximeter) and PaO2 (Corning 178) measured on blood from an indwelling arterial catheter. For each infant, the fractional inspiratory oxygen (FiO2) was adjusted to obtain three to five sets of data in the range of 70% to 95% SaO2. Fifty-three data points were generated and pooled for analysis. The slope of the regression line generated for the Nellcor 100 was .86; for the BTI Biox III, it was .91; and for the Sensor Medics Transend, it was .55, resulting in average errors of +2.5%, +1.0%, and -29%, respectively, when comparing corresponding transcutaneous and arterial values. When SaO2 was equal to or less than 95%, no infants were hyperoxic. These data confirm reports by others that tcPO2 values do not accurately represent PaO2 values in older infants with bronchopulmonary dysplasia. Pulse oximeters do not require user calibration, and their sensor is unheated so they will not cause skin burns. We conclude that pulse oximetry offers major advantages over tcPO2 measurements in the management of infants with bronchopulmonary dysplasia.