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Validation of oxygen saturation monitoring in neonates.
Am J Crit Care. 2007 Mar; 16(2):168-78.AJ

Abstract

BACKGROUND

Pulse oximetry is commonly used to monitor oxygenation in neonates, but cannot detect variations in hemoglobin. Venous and arterial oxygen saturations are rarely monitored. Few data are available to validate measurements of oxygen saturation in neonates (venous, arterial, or pulse oximetric). Purpose To validate oxygen saturation displayed on clinical monitors against analyses (with correction for fetal hemoglobin) of blood samples from neonates and to present the oxyhemoglobin dissociation curve for neonates.

METHOD

Seventy-eight neonates, 25 to 38 weeks' gestational age, had 660 arterial and 111 venous blood samples collected for analysis.

RESULTS

The mean difference between oxygen saturation and oxyhemoglobin level was 3% (SD 1.0) in arterial blood and 3% (SD 1.1) in venous blood. The mean difference between arterial oxygen saturation displayed on the monitor and oxyhemoglobin in arterial blood samples was 2% (SD 2.0); between venous oxygen saturation displayed on the monitor and oxyhemoglobin in venous blood samples it was 3% (SD 2.1) and between oxygen saturation as determined by pulse oximetry and oxyhemoglobin in arterial blood samples it was 2.5% (SD 3.1). At a Pao(2) of 50 to 75 mm Hg on the oxyhemoglobin dissociation curve, oxyhemoglobin in arterial blood samples was from 92% to 95%; oxygen saturation was from 95% to 98% in arterial blood samples, from 94% to 97% on the monitor, and from 95% to 97% according to pulse oximetry.

CONCLUSIONS

The safety limits for pulse oximeters are higher and narrower in neonates (95%-97%) than in adults, and clinical guidelines for neonates may require modification.

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Authors+Show Affiliations

Shiao SY
School of Nursing, University of Houston Victoria and University of Houston System at Sugar Land, Sugar Land, TX 77479, USA. shiaop@uhv.edu
Ou CN
No affiliation info available

MeSH

FemaleHeart Defects, CongenitalHemoglobinsHumansInfant, NewbornMaleMonitoring, PhysiologicOximetryOxygenRespiration, ArtificialRespiratory Distress Syndrome, Newborn

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

17322018

Citation

Shiao, Shyang-Yun Pamela K., and Ching-Nan Ou. "Validation of Oxygen Saturation Monitoring in Neonates." American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses, vol. 16, no. 2, 2007, pp. 168-78.
Shiao SY, Ou CN. Validation of oxygen saturation monitoring in neonates. Am J Crit Care. 2007;16(2):168-78.
Shiao, S. Y., & Ou, C. N. (2007). Validation of oxygen saturation monitoring in neonates. American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses, 16(2), 168-78.
Shiao SY, Ou CN. Validation of Oxygen Saturation Monitoring in Neonates. Am J Crit Care. 2007;16(2):168-78. PubMed PMID: 17322018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of oxygen saturation monitoring in neonates. AU - Shiao,Shyang-Yun Pamela K, AU - Ou,Ching-Nan, PY - 2007/2/27/pubmed PY - 2007/5/4/medline PY - 2007/2/27/entrez SP - 168 EP - 78 JF - American journal of critical care : an official publication, American Association of Critical-Care Nurses JO - Am J Crit Care VL - 16 IS - 2 N2 - BACKGROUND: Pulse oximetry is commonly used to monitor oxygenation in neonates, but cannot detect variations in hemoglobin. Venous and arterial oxygen saturations are rarely monitored. Few data are available to validate measurements of oxygen saturation in neonates (venous, arterial, or pulse oximetric). Purpose To validate oxygen saturation displayed on clinical monitors against analyses (with correction for fetal hemoglobin) of blood samples from neonates and to present the oxyhemoglobin dissociation curve for neonates. METHOD: Seventy-eight neonates, 25 to 38 weeks' gestational age, had 660 arterial and 111 venous blood samples collected for analysis. RESULTS: The mean difference between oxygen saturation and oxyhemoglobin level was 3% (SD 1.0) in arterial blood and 3% (SD 1.1) in venous blood. The mean difference between arterial oxygen saturation displayed on the monitor and oxyhemoglobin in arterial blood samples was 2% (SD 2.0); between venous oxygen saturation displayed on the monitor and oxyhemoglobin in venous blood samples it was 3% (SD 2.1) and between oxygen saturation as determined by pulse oximetry and oxyhemoglobin in arterial blood samples it was 2.5% (SD 3.1). At a Pao(2) of 50 to 75 mm Hg on the oxyhemoglobin dissociation curve, oxyhemoglobin in arterial blood samples was from 92% to 95%; oxygen saturation was from 95% to 98% in arterial blood samples, from 94% to 97% on the monitor, and from 95% to 97% according to pulse oximetry. CONCLUSIONS: The safety limits for pulse oximeters are higher and narrower in neonates (95%-97%) than in adults, and clinical guidelines for neonates may require modification. SN - 1062-3264 UR - https://www.unboundmedicine.com/medline/citation/17322018/Validation_of_oxygen_saturation_monitoring_in_neonates_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17322018.ui DB - PRIME DP - Unbound Medicine ER -