Defining the Reference Range for Oxygen Saturation for Infants After Birth

Dawson, Jennifer A; Kamlin, C. Omar F.; Vento, Máximo; Wong, Connie; Cole, Tim J.; Donath, Susan; Davis, Peter G; Morley, Colin J

doi:10.1542/peds.2009-1510

Cited by 504 publications

(450 citation statements)

References 27 publications

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“…We found that it took 7.4 minutes to reach a median pre- [10][11][12][13]. Our study supports the assertion that during neonatal transition oxyhemoglobin saturation does not reach 90% until approximately 10 minutes of life.…”

Section: Discussionsupporting

confidence: 88%

“…There have been similar studies both in the past and more recently, having smaller and even larger numbers of infants, from centres across all continents [10][11][12][13][14][15][16]. Kamlin et al determined the range of only pre-ductal SpO 2 in 92 patients who were found to have a median SpO 2 of 90% at 5 minutes [12].…”

Section: Discussionmentioning

confidence: 87%

“…Rabi et al found that median SpO 2 did not reach 90% until 8 minutes of life, a little earlier in vaginally born neonates when compared to those born through a caesarean section [11]. Dawson and co workers also presented reference ranges of SpO 2 values for term, pre term and extremely pre term infants [13].…”

Section: Discussionmentioning

confidence: 99%

“…The 2010 ILCOR recommendations state that resuscitation can be initiated with room air or blended oxygen but it should be guided by measurement of oxygen saturation using pulse oximetry and the target saturation should fall in the interquartile range of preductal saturations measured in healthy term babies following vaginal birth at sea level [2]. These recommendations are based on the existing data on oxygen saturation of healthy term newborns in the first few minutes of life [10][11][12][13][14][15][16]. While such data exists in abundance, it is lacking as far as Indian population is concerned.…”

Section: Introductionmentioning

confidence: 99%

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Oxygen Saturation Profile in Healthy Term Neonates in the Immediate Post Natal Period

Tiwari

2013

Int J Clin Pediatr

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Background: A neonate undergoes major physiologic changes during transition from intrauterine to extrauterine period. The percentage saturation of hemoglobin takes about 10 minutes to reach a level of more than 90%. This fact is to be borne in mind while resuscitating a newborn with oxygen to avoid its toxicity. It is still unclear whether the oxygen saturation profile could be affected by racial/ethnic variation, birth weight, sex, APGAR score or maternal factors (age, hemoglobin, type of labor) in term healthy babies. This study aimed: 1) To note the time taken for SpO 2 to reach a value of 90%; 2) To note the time taken for preductal and post ductal SpO 2 to equalize; 3) To look for the association between SpO 2 and various infant and maternal factors.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oxygen Saturation Profile in Healthy Term Neonates in the Immediate Post Natal Period

Tiwari

2013

Int J Clin Pediatr

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“…Under these circumstances especially sensitive tissues, such as the retina and choroid are vulnerable towards damage. It is therefore important to define a safety range of postnatal oxygenation that would avoid damage caused by both hyper-and/or-hypoxia in the immediate postnatal period (2), and thereafter (1).…”

mentioning

confidence: 99%

Metabolic adaptation and neuroprotection differ in the retina and choroid in a piglet model of acute postnatal hypoxia

et al. 2014

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Background: Hypoxic-ischemic insults to the neonatal brain may cause neurodevelopmental disorders. Vulnerability of different areas of the neural tissue to hypoxic-ischemic stress might be explained by either heterogeneous sensitivity to oxygen or neuroprotective capability. Our understanding of regional heterogeneity is still incomplete in terms of metabolic reconfiguration and/or activation of neuroprotective mechanisms. Methods: We studied, by western blotting, reversetranscriptase PCR, and tandem mass spectrometry, the response of retina and choroid at protein, gene, and metabolic levels during hypoxia in a piglet model of acute postnatal hypoxia. results: We evidenced a metabolic shift towards glycolysis in choroid after hypoxia while retina experienced a dramatic energy stress with decreased mitochondrial metabolites. Hypoxia-inducible transcription factor-1α (HIF-1α) was not stabilized in retina during hypoxia, supported by a deficient signaling from v-akt murine thymoma viral oncogene (AKT) and ERK1/2, and unchanged glutathione redox status. In retina, but not in choroid, phosphorylation of p65 (NF-κB) and increased transcription of target genes may have a major role during hypoxic stress. conclusion: We showed that the retina engages a distinct pattern of signaling and transcriptional events than observed in the choroid. Retina and choroid may reflect regional sensitivity to hypoxia. While prolonged and intense hypoxia may jeopardize retinal cell survival, choroid sets up a different pattern of response, which promotes adaptation to these adverse conditions.

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Frequency, Timing, Risk Factors, and Outcomes of Desaturation in Infants With Acute Bronchiolitis and Initially Normal Oxygen Saturation

et al. 2020

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IMPORTANCELittle is known about the natural course of oxygen desaturation in acute bronchiolitis.Information on risk factors associated with desaturation as well as the time to desaturation in infants with bronchiolitis could help physicians better treat these infants before deciding whether to hospitalize them. OBJECTIVETo prospectively determine the frequency of desaturation in infants with bronchiolitis, along with the time to desaturation and risk factors associated with desaturation, and to compare infants who were hospitalized with those discharged home and evaluate risk factors for rehospitalization. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted during the 2017 to 2018 and 2018 to 2019 respiratory syncytial virus seasons in a tertiary care pediatric emergency department in Switzerland. Included individuals were 239 otherwise-healthy infants aged younger than 1 year, diagnosed with acute bronchiolitis and oxygen saturation of 90% or more on arrival. Data were analyzed from July 2019 to October 2020. EXPOSURES After receiving triage care, study participants admitted to the emergency department were equipped with a pulse oximeter to continuously record oxygen saturation (SpO 2 levels), regardless of subsequent hospitalization or discharge home. MAIN OUTCOMES AND MEASURESThe primary outcome was desaturation (ie, SpO 2 < 90%) during the first 36 hours. RESULTSOf 239 infants enrolled, with a median (interquartile range [IQR]) age of 3.9 (1.5-6.5) months, 116 (48.5%) were boys and desaturation occurred in 165 infants (69.0%). Median (IQR) time to desaturation was 3.6 (1.8-9.4) hours. The rate of desaturation was similar between infants hospitalized and those discharged home (137 of 200 infants [68.5%] vs 28 of 39 infants [71.8%]; difference, −3.3%; 95% CI, −18.8% to 12.2%; P = .85). A more severe initial clinical presentation with moderate or severe retractions was the only independent risk factor associated with desaturation (odds ratio, 2.73; 95% CI, 1.49 to 5.02; P = .001). Of 39 infants discharged home, 22 infants (56.4%) experienced major desaturations. However, infants with desaturations, including those with major desaturations, had rates of rehospitalization similar to those of infants without desaturations (8 of 28 infants [28.5%] vs 3 of 11 infants [27.3%]; difference, 1.2%; 95% CI, −29.9% to 32.5; P > .99). CONCLUSIONS AND RELEVANCEThese findings suggest that rates of desaturation in infants with acute bronchiolitis were high and similar between infants who were hospitalized and those discharged home. A more severe initial clinical presentation was the only risk factor associated with (continued) Key Points Question What are the frequency, timing, risk factors, and outcomes associated with oxygen desaturation in infants with acute bronchiolitis and initially normal oxygen saturation? Findings In this cohort study of 239 infants, desaturation occurred in most infants, regardless of whether they were hospitalized or discharged home. A more severe initial clinical presentation was the ...

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Defining the Reference Range for Oxygen Saturation for Infants After Birth

Abstract: These data represent reference ranges for Spo(2) in the first 10 minutes after birth for preterm and term infants.

Cited by 504 publications

References 27 publications

Oxygen Saturation Profile in Healthy Term Neonates in the Immediate Post Natal Period

Oxygen Saturation Profile in Healthy Term Neonates in the Immediate Post Natal Period

Metabolic adaptation and neuroprotection differ in the retina and choroid in a piglet model of acute postnatal hypoxia

Frequency, Timing, Risk Factors, and Outcomes of Desaturation in Infants With Acute Bronchiolitis and Initially Normal Oxygen Saturation

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