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

Levesque, Bernadette M.; Pollack, Phyllis; Griffin, Braden E.; Nielsen, Heber C.

doi:10.1002/1099-0496(200011)30:5<406::aid-ppul7>3.0.co;2-c

Cited by 62 publications

(40 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Part 2, we only measured post‐ductal SpO 2 due to resource limitations. Studies have demonstrated that pre‐ductal SpO 2 is higher in the first 4 h42, 43, 44 but becomes equal to post‐ductal SpO 2 by 18–24 h 45, 46. Post‐ductal measurements were obtained at all time points, and ≥50% of neonates were above target at all time points; thus, we do not believe this affected our results.…”

Section: Discussionmentioning

confidence: 99%

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Morgan

Maina

Waiyego

et al. 2017

J Paediatrics Child Health

View full text Add to dashboard Cite

AimThere are 2.7 million neonatal deaths annually, 75% of which occur in sub‐Saharan Africa and South Asia. Effective treatment of hypoxaemia through tailored oxygen therapy could reduce neonatal mortality and prevent oxygen toxicity.MethodsWe undertook a two‐part prospective study of neonates admitted to a neonatal unit in Nairobi, Kenya, between January and December 2015. We determined the prevalence of hypoxaemia and explored associations of clinical risk factors and signs of respiratory distress with hypoxaemia and mortality. After staff training on oxygen saturation (SpO2) target ranges, we enrolled a consecutive sample of neonates admitted for oxygen and measured SpO2 at 0, 6, 12, 18 and 24 h post‐admission. We estimated the proportion of neonates outside the target range (≥34 weeks: ≥92%; <34 weeks: 89–93%) with 95% confidence intervals (CIs).ResultsA total of 477 neonates were enrolled. Prevalence of hypoxaemia was 29.2%. Retractions (odds ratio (OR) 2.83, 95% CI 1.47–5.47), nasal flaring (OR 2.68, 95% CI 1.51–4.75), and grunting (OR 2.47, 95% CI 1.27–4.80) were significantly associated with hypoxaemia. Nasal flaring (OR 2.85, 95% CI 1.25–6.54), and hypoxaemia (OR 3.06, 95% CI 1.54–6.07) were significantly associated with mortality; 64% of neonates receiving oxygen were out of range at ≥2 time points and 43% at ≥3 time points.ConclusionThere is a high prevalence of hypoxaemia at admission and a strong association between hypoxaemia and mortality in this Kenyan neonatal unit. Many neonates had out of range SpO2 values while receiving oxygen. Further research is needed to test strategies aimed at improving the accuracy of oxygen provision in low‐resource settings.

show abstract

Section: Discussionmentioning

confidence: 99%

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Morgan

Maina

Waiyego

et al. 2017

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…12,[17][18][19][20] Some studies have assessed oxygen saturation from single sites alone and others from both pre-and postductal sites. The pre-and postductal saturations were obtained by sequential measurements 15,18,19 in some studies and by simultaneous measurements in others. 12,16 Rosvik et al 20 described postductal saturation in the first 6 hours in .6800 newborns screened for CCHD, but there has been no similar study using both pre-and postductal oxygen saturation.…”

mentioning

confidence: 80%

“…Our current knowledge of oxygen saturation in newborns comes from studies done immediately after birth [12][13][14][15][16] and in the first 24 hours after birth. 12,[17][18][19][20] Some studies have assessed oxygen saturation from single sites alone and others from both pre-and postductal sites. The pre-and postductal saturations were obtained by sequential measurements 15,18,19 in some studies and by simultaneous measurements in others.…”

mentioning

confidence: 99%

Oxygen Saturation Nomogram in Newborns Screened for Critical Congenital Heart Disease

et al. 2013

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Universal oxygen saturation screening by pulse oximetry is now recommended for early detection of critical congenital heart disease. The distribution of saturations in asymptomatic newborns in a large population has not been described. WHAT THIS STUDY ADDS:Our study is the largest to date to establish simultaneous pre-and postductal oxygen saturation nomograms in asymptomatic newborns at ∼24 hours after birth. The mean postductal saturation is higher than preductal during this time.abstract OBJECTIVE: To establish simultaneous pre-and postductal oxygen saturation nomograms in asymptomatic newborns when screening for critical congenital heart disease (CCHD) at ∼24 hours after birth.METHODS: Asymptomatic term and late preterm newborns admitted to the newborn nursery were screened with simultaneous pre-and postductal oxygen saturation measurements at ∼24 hours after birth. The screening program was implemented in a stepwise fashion in 3 different affiliated institutions. Data were collected prospectively from July 2009 to March 2012 in all 3 centers. RESULTS:We screened 13 714 healthy newborns at a median age of 25 hours. The mean preductal saturation was 98.29% (95% confidence interval [CI]: 98.27-98.31), median 98%, and mean postductal saturation was 98.57% (95% CI: 98.55-98.60), median 99%. The mean difference between the pre-and postductal saturation was 20.29% (95% CI: 20.31 to 20.27) with P , .00005. Its clinical relevance to CCHD screening remains to be determined. The postductal saturation was equal to preductal saturation in 38% and greater than preductal saturation in 40% of the screens. CONCLUSIONS:We have established simultaneous pre-and postductal oxygen saturation nomograms at ∼24 hours after birth based on .13 000 asymptomatic newborns. Such nomograms are important to optimize screening thresholds and methodology for detecting CCHD.

show abstract

“…60 The difference between right hand and lower limb saturations reflects right-to-left shunting across the ductus arteriosus and this generally diminishes with time in most infants, with both pre-and postductal saturations reaching 95% by 1 hour of age. 60 Saturations are generally stable in the first 24 hours with a mean of 98% (similar to values obtained from older neonates); however, periods of desaturation may occur, 61 and larger studies have shown that many healthy newborns (up to 5%) may have episodes of saturations of < 95% within the first 24 hours. 13 These findings have led to exploration of the possibility that pulse oximetry may be useful in detecting hypoxaemia associated with CHDs in apparently healthy newborns, and a number of studies have been published that have used pulse oximetry as a screen for CHDs in this group.…”

Section: Pulse Oximetrymentioning

confidence: 99%

Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness.

Ewer

Furmston²,

Middleton³

et al. 2012

Health Technol Assess

127

117

View full text Add to dashboard Cite

How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAPulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'Na...

show abstract

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

Cited by 62 publications

References 22 publications

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Oxygen Saturation Nomogram in Newborns Screened for Critical Congenital Heart Disease

Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and cost-effectiveness.

Contact Info

Product

Resources

About