Reliability of Conventional and New Pulse Oximetry in Neonatal Patients

Hay, William W.; Rodden, Donna J; Collins, Shannon M.; Melara, Diane L; Hale, Kathy; Fashaw, Lucy M

doi:10.1038/sj.jp.7210740

Cited by 150 publications

(85 citation statements)

References 19 publications

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“…Fourth, technical considerations of the pulse oximeters (averaging time, motion artifacts and features to limit nuisance alarms) should not influence the distribution of SpO 2 values for either group as the same pulse oximeter was used in each period. 13,14 Specific information regarding location of the pulse oximeter (pre-vs postductal) is not available. A final consideration is that as groups 1 and 2 were studied over sequential time periods, differences in patient characteristics and patient care practices cannot be excluded as contributing to the observed distribution of SpO 2 values.…”

Section: Discussionmentioning

confidence: 99%

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

et al. 2006

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Objective: To determine if a change in the pulse oximeter goal range and high alarm limit for oxygen saturation (SpO 2 ) alters the distribution of SpO 2 for premature infants in oxygen.Study design: This was a prospective, observational analysis. For group 1 (February 2002 to April 2002, n ¼ 23), pulse oximeter alarms were set at 80% (low) and 96% (high), and the goal range was 90-95%. For group 2 (May 2002 to August 2003, n ¼ 49), the high alarm was lowered to 94%, and the goal range was 88 to 94%. The SpO 2 values for 24 h were downloaded from Nellcor pulse oximeters during the two periods and the percent time within, above and below the goal range was derived and compared.Results: Groups were similar except for use of post-natal steroids (group 2>1). The percent time within (57.7±9.8 vs 59.4±12.4%), above (15.4±10.6 vs 14±9.4%) and below (26.9±9.7 vs 26.6±10.2%) the goal range was similar for groups 1 and 2, respectively. However, the percent time with SpO 2 <80% increased significantly for group 2 (4.0±2.7 vs 1.9±1.4%).Conclusions: Changes in pulse oximeter policy and alarms in labile, sick premature infants need evaluation for their effects on the distribution of SpO 2 values before routine use.

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Section: Discussionmentioning

confidence: 99%

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

et al. 2006

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“…It further needs an evaluation for prolonged continuous monitoring as compared to the commonly used TPO, and it needs to be compared to other modern transmission pulse oximeters like the Masimo SET that might be advantageous as compared to the Nellcor N395, according to few recent studies. 17 One of the limitations of our study was the wide range of study weight and postnatal age, and in future studies, will evaluate the RPO in unique groups of infants like very low birth-weight infants (<1500 g).…”

Section: Discussionmentioning

confidence: 95%

“…6 In order to minimize these limitations, new transmission pulse oximeters were recently introduced. 17 A different approach to solve these problems was to develop the RPO. The RPO is designed to measure SpO 2 by reflectance of the signal from the tissue, and not by transmission of the signal through the tissue.…”

Section: Discussionmentioning

confidence: 99%

Reflectance Pulse Oximetry from Core Body in Neonates and Infants: Comparison to Arterial Blood Oxygen Saturation and to Transmission Pulse Oximetry

et al. 2004

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OBJECTIVE:To compare pulse oximetry oxygen saturation (SpO 2 ) measured by a novel reflectance method from core body to arterial oxygen saturation (SaO 2 ) in neonates and infants. Transmission pulse oximetry (TPO) was measured for comparison. STUDY DESIGN:We monitored 18 infants by the two pulse oximeters simultaneously. The reflectance pulse oximetry (RPO) (PRO2, ConMed, Utica, NY) was measured on the upper back or chest, while the TPO (N395-Nellcor, Pleasanton, CA) was measured from the finger of the infant on the left hand or feet. Data from the two methods were compared to functional SaO 2 derived from blood sample drawn from arterial line for patient care and measured by a Co-oximeter (Ilex, Instrument Lab. Lexington, MA). The potential advantage of the RPO is demonstrated in a case of a premature infant with hypovolemic shock, where SaO 2 or TPO could not be obtained but oximetry was available from the RPO. RESULTS:We used for analysis 56 RPO and 32 TPO measurements. SpO 2 obtained from the RPO was 88.3±9.8%, from the TPO 84.2±10.1%, and functional SaO 2 was 88.2±11.7%, with correlation coefficient of 0.93 and 0.88, respectively (p<0.0001). The mean difference (bias) and standard deviation of the differences (precision) between the RPO and the TPO compared to functional SaO 2 were À0.09±4.5% and 1.26±5.9% and the absolute errors were 3.2±3.1%, and 4.4±4.0%, respectively. The accuracy of both RPO and TPO was diminished when SaO 2 was <85%, but only the RPO remained correlated with the functional SaO 2 .CONCLUSIONS: Reflectance pulse oximetry measured from core body of neonates and infants is accurate and reliable and is comparable to the transmission SpO 2 when compared to functional SaO 2 . We speculate that the reflectance method might be advantageous in cases of poor peripheral perfusion in neonates and infants.

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“…The advantages of SpO 2 monitors with signal extraction technology (Masimo SET) during situations of low perfusion and motion have been previously described. [7][8][9][10][11] SpO 2 monitoring is based on the relation between hemoglobin (Hb) and oxygen. Bohr showed that the dissociation curve was sigmoid shaped, with an initial relative horizontal portion, followed by a vertical one, ending again with a horizontal shape.…”

Section: Arterial Oxygen Saturationmentioning

confidence: 99%

“…Since some monitors are better than others, a similar or even larger disparity in SpO 2 simultaneous readings between different SpO 2 monitors exists. [7][8][9][10][11]16 When SpO 2 is 97% in one monitor, the true SaO 2 and the SpO 2 in another monitor could be 100%. Therefore, accepting the imprecision of the real world, the one SpO 2 value cannot be the sole focus.…”

Section: Tension Of Arterial Oxygen (Pao 2 )mentioning

confidence: 99%

Clinical practices in neonatal oxygenation: where have we failed? What can we do?

2008

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Reliability of Conventional and New Pulse Oximetry in Neonatal Patients

Cited by 150 publications

References 19 publications

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Reflectance Pulse Oximetry from Core Body in Neonates and Infants: Comparison to Arterial Blood Oxygen Saturation and to Transmission Pulse Oximetry

Clinical practices in neonatal oxygenation: where have we failed? What can we do?

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