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Transcutaneous monitoring of oxygenation: what is normal?
Insights
Transcutaneous oxygen saturation (tcSao2) and tension (tcPo2) in infants change with state, not just age after the first week. These findings help manage oxygen-dependent infants with chronic lung disease.
Area of Science:
- Neonatal physiology
- Respiratory medicine
- Pediatric critical care
Background:
- Establishing normal reference ranges for transcutaneous blood gas measurements in infants is crucial for managing chronic lung disease.
- Infant physiological parameters, including oxygenation, can vary significantly based on activity and sleep states.
Purpose of the Study:
- To obtain normal data for transcutaneous oxygen tension (tcPo2) and saturation (tcSao2) in infants from birth to 6 months.
- To establish guidelines for managing oxygen-dependent infants with chronic lung disease based on physiological data.
Main Methods:
- Monitoring tcPo2 and tcSao2 in 55 infants over 119 occasions from birth to 6 months.
- Measurements were taken during four distinct infant states: awake, feeding, quiet sleep, and active sleep.
Main Results:
- Lowest tcSao2 values were observed in the first week of life across all states.
- After the first week, infant state significantly impacted tcSao2 and tcPo2, more so than age.
- Significant differences in tcSao2 and tcPo2 were noted between awake, feeding, and sleeping states (P < 0.0001).
Conclusions:
- Transcutaneous blood gas measurements in infants are significantly influenced by the infant's state.
- These findings provide essential data for the clinical management of oxygen-dependent infants with chronic lung disease.
Abstract:
We examined 55 infants on 119 occasions, from birth to 6 months, to obtain normal data and to establish guidelines for the management of oxygen-dependent infants with chronic lung disease. Transcutaneous oxygen tension (tcPo2) and saturation (tcSao2) were monitored during four states: awake, feeding, quiet sleep, and active sleep. Lowest values (mean +/- SD) for tcSao2 were recorded in all states during the first week of life: awake 96.2% +/- 2.6%, feeding 91.2% +/- 3.7%, quiet sleep 93.2% +/- 2.9%, and active sleep 92.1% +/- 2.9%. After the first week the results were affected by state rather than age, with differences observed between awake and feeding (P less than 0.0001), awake and asleep (P less than 0.00001), and quiet sleep and active sleep (P less than 0.001). The findings for tcPo2 were less consistent and probably affected by the characteristics of skin. In the first week, values were as follows: awake 83.5 +/- 10.1 mm Hg, feeding 73.4 +/- 10.1 mm Hg, quiet sleep 78.5 +/- 10.9 mm Hg, and active sleep 73.4 +/- 11.4 mm Hg. Subsequently, only the state effect remained, and significant differences existed between awake and feeding (P less than 0.0001) and awake and asleep (P less than 0.00001). We conclude that transcutaneous blood gas measurements are affected by state of the infant.