Pulse oximeter and transcutaneous arterial oxygen measurements in neonatal and paediatric intensive care.

Southall, D P; Bignall, S; Stebbens, V A; Alexander, Jr; Rivers, R. P. A.; Lissauer, Tom

doi:10.1136/adc.62.9.882

Cited by 90 publications

(15 citation statements)

References 14 publications

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“…In this study we used a pulse oximeter that has been validated against arterial line measurements in infants. 3 We also used the oximeter in the beat to beat mode. Most infants, despite a high baseline measurement of SaO2, showed drops in oxygenation to levels below a threshold which has been previously defined as indicating an 'abnormal' reaction to an apnoeic pause.…”

Section: Discussionmentioning

confidence: 99%

Oxygen saturation and breathing patterns in infancy. 1: Full term infants in the second month of life.

Stebbens

Poets

Alexander

et al. 1991

Archives of Disease in Childhood

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101

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Overnight 12 hour tape recordings were made of arterial oxygen saturation (SaO2, pulse oximeter in the beat to beat mode) and abdominal wall breathing movement on 67 healthy, full term infants between the ages of 29 and 54 (median 39) days. The median baseline SaO2 during regular breathing was 99-8% (range 97-0-100%). Fifty four infants (81%) had shortlived episodes during which SaO2 fell to 80% or less (desaturation); the median rate was 0-9 desaturations/hour, and the median duration of each desaturation was 1-2 seconds. The 97th centile value for the duration of all episodes in which SaO2 fell to 680% was 4-0 seconds. The frequency of desaturations was significantly higher, and their duration significantly longer, when the breathing pattern was non-regular rather than regular. The percentage of apnoeic pauses (¢4 seconds in duration) followed by a desaturation was higher during non-regular than regular breathing; it was particularly high during periodic breathing.A knowledge of normal variability of baseline measurements of oxygenation and of the relationship between oxygenation and breathing patterns in infants is essential to the use of pulse oximetry in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Oxygen saturation and breathing patterns in infancy. 1: Full term infants in the second month of life.

Stebbens

Poets

Alexander

et al. 1991

Archives of Disease in Childhood

Self Cite

101

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“…Using a pulse oximeter validated against arterial line samples (8,9), and modified to provide beat-to-beat measurements, recurrent short-lived hypoxaemic episodes have been identified in both healthy preterm and full-term infants (10, 11). Such episodes were short in duration, with 95% lasting for less than 4 s in full-term infants.…”

Section: -5253mentioning

confidence: 99%

Oxygen saturation and breathing patterns in preterm infants with cyanotic episodes

Samuels¹,

Poets²,

Stebbens³

et al. 1992

Acta Paediatrica

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The pathophysiology of cyanotic/apnoeic episodes in preterm infants was investigated using overnight tape recordings of beat-to-beat arterial oxygen saturation (SaO2), plethysmographic waveforms from the oximeter, breathing movements and nasal airflow. Recordings were made in 16 preterm infants with recurrent cyanotic episodes of unknown cause that had received stimulation or resuscitation, and 15 preterm controls, matched for birth weight, post-conceptional and postnatal age. The recordings were analysed for baseline SaO2, the number of hypoxaemic episodes (SaO2 < or = 80% for > or = 4 s) and the breathing patterns associated with each episode. There was a significant difference in the total number of hypoxaemic episodes between patients and controls (520 versus 100; p < 0.01), but no difference was found for mean baseline SaO2 (98.6 versus 99.0%; p > 0.05). The mean duration of each hypoxaemic episode in the patients was 9.5 s compared with 5.8 s in the controls (p < 0.01). Although most hypoxaemic episodes (62 and 76%) were associated with pauses in breathing movements, a proportion (8 and 18%, respectively) occurred despite continuous airflow and breathing movements in both patients (6 of 16) and preterm controls (2 of 15). The rate of decrease in SaO2 was significantly more rapid during these latter hypoxaemic episodes than during episodes associated with isolated apnoeic pauses (8.5 versus 3.2% per second, p = 0.02). Preterm infants with cyanotic episodes have increased numbers of clinically unapparent hypoxaemic episodes, some of which have continued ventilation and rapid desaturation. The pathogenesis of these episodes warrants further investigation.

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“…Since its introduction, numerous studies have shown the pulse oximeter to be accurate and reliable in neonates. [1][2][3][4][5][6] Normative ranges for pulse oximetry saturation in children [7][8][9] and adults 10 have been well established. In contrast, normal pulse oximetry saturations have not been well established for healthy term newborn infants in the first hours and days of life.…”

Section: Introductionmentioning

confidence: 99%

Pulse oximetry: What's normal in the newborn nursery?

et al. 2000

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Pulse oximeter and transcutaneous arterial oxygen measurements in neonatal and paediatric intensive care.

Cited by 90 publications

References 14 publications

Oxygen saturation and breathing patterns in infancy. 1: Full term infants in the second month of life.

Oxygen saturation and breathing patterns in infancy. 1: Full term infants in the second month of life.

Oxygen saturation and breathing patterns in preterm infants with cyanotic episodes

Pulse oximetry: What's normal in the newborn nursery?

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