The use of overnight oximetry in neonates: A literature review

Flint, Anndrea; Davies, Mark W

doi:10.1111/jpc.13935

Cited by 9 publications

(7 citation statements)

References 40 publications

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“…Oximeters and their analysis software are advancing in technology, but there are few detailed guidelines on how these recordings should be performed or interpreted . In New Zealand (NZ), there are guidelines from 2009 from Auckland's Starship Children's Hospital on performing and interpreting paediatric oximetry.…”

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confidence: 99%

Comparison of 12‐hour and 24‐hour oximetry recordings in preterm infants

Wellington

Campbell

Elder

2018

J Paediatrics Child Health

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Aim: To compare the overnight 12-hour oximetry component of 24-hour oximetry recordings with the complete 24-h recording in terms of cardiorespiratory status data in preterm infants. Methods: Preterm infants from the Wellington neonatal intensive care unit underwent a 24-h pulse oximetry recording immediately prior to discharge home. Each recording was edited to resemble a 12-h overnight recording and compared to the full 24-h recording. Differences in a range of cardiorespiratory variables were assessed as to whether they were statistically significant and, if so, likely to be clinically significant. Results: The nadirs for heart rate and SpO 2 (both P < 0.001), the time spent <80% SpO 2 (P = 0.017) and highest heart rate (P < 0.001) were significantly different between the two recordings. Only the heart rate nadir differed by more than 5%, suggesting that this may be of clinical significance (median (interquartile range) 54 (28-69) for 24-h recording vs. 78 (54-96) for 12-h recording). Conclusion:The 24-h oximetry reports were clinically similar to 12-h recordings for the majority of variables, and therefore, we suggest that 12-h oximetry studies are sufficient for determining cardiorespiratory status in infants.

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confidence: 99%

Comparison of 12‐hour and 24‐hour oximetry recordings in preterm infants

Wellington

Campbell

Elder

2018

J Paediatrics Child Health

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“…14,15 There is currently a paucity of literature describing recorded nocturnal oximetry at home in infants with BPD who clinically appear ready to wean from supplemental oxygen. 16,17 With the capability to detect subtle desaturation events that may not be readily apparent by clinical observation, we sought to gather more insight to high-risk patterns associated with both short-and long-term morbidity that may have been previously unrecognized. We performed a descriptive review of recorded nocturnal oximetry data collected in infants with BPD who were discharged home with supplemental oxygen to evaluate whether oximetry tests identified otherwise undetected hypoxemia in this population.…”

Section: Introductionmentioning

confidence: 99%

Frequent hypoxemia found in infants with bronchopulmonary dysplasia after weaning home oxygen

House

Klein

Parham

et al. 2022

Pediatric Pulmonology

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Objective Parental reports and brief clinical examinations are the primary information used to assist clinicians in weaning home supplemental oxygen in infants with bronchopulmonary dysplasia (BPD). Recorded nocturnal oximetry provides an objective assessment of hypoxemia; however, it is unknown if it identifies clinically undetected hypoxemia in the home setting. Our objective was to determine if nocturnal oximetry can identify unreported hypoxemia in infants with BPD who appear ready to wean from supplemental oxygen. Study Design We conducted a retrospective chart review of infants born <32 weeks gestation with BPD who were discharged to home receiving supplemental oxygen and completed recorded nocturnal oximetry in room air during an 18‐month period. Abnormal oximetry was defined as >5 min with SpO2 < 90% and/or an oxyhemoglobin desaturation index (ODI4) >5. Comparative analysis of patients with normal and abnormal overnight oximetry was performed using Fisher Exact and Wilcoxon signed‐rank test. Results Thirty‐five former premature infants completed nocturnal oximetry at 5.8 (3.4−8.3) months corrected age. Nocturnal oximetry was abnormal as defined in 67% of the cohort (n = 21). Five percent of patients were hypoxemic, 52% had frequent desaturation events, and 43% had both. No significant differences existed in neonatal characteristics between patients with normal and abnormal studies. Conclusions Nocturnal oximetry was abnormal in the majority of infants with BPD who were otherwise clinically ready to wean from oxygen support, suggesting that recorded home oximetry could be a feasible and useful tool to evaluate for otherwise clinically unapparent nocturnal hypoxemia in patients with BPD.

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“…Some centers have suggested that PSGs should be performed in all infants on HOT before discontinuing oxygen, where it is considered the gold standard for diagnosing sleep‐disordered breathing 8–10 . PSGs provide several respiratory parameters, but not all parameters may be relevant to determine whether oxygen can be discontinued.…”

Section: Introductionmentioning

confidence: 99%

Does recorded oximetry utilizing a consensus‐based algorithm compare to polysomnography in discontinuing home oxygen therapy in premature infants?

White

Sobelman

Kremer

et al. 2021

Pediatric Pulmonology

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Background Approximately a third of all extremely preterm infants diagnosed with bronchopulmonary dysplasia will require home oxygen therapy (HOT). Lack of consensus‐based guidelines has led to significant variability in outpatient HOT management in the United States. A common assessment performed before discontinuing oxygen is a formal polysomnogram (PSG). PSGs are potentially undesirable due to cost, lack of convenient access, and parental stress, so alternative testing to determine the optimal timing of safe oxygen discontinuation are needed. Methods We compared nocturnal recorded home oximetry (RHO) with PSG data in a cohort of patients from the RHO trial for patients who had recordings performed simultaneously to or within 24 h of their PSG. The RHO trial was a randomized, unblinded, multi‐center trial comparing two oxygen management strategies. Parameters of oxygenation were compared between PSG and RHO, and nonoximegtry findings from the PSG that changed clinical management were identified. Results A total of 53 infants randomized to obtain a PSG as part of the RHO trial (55%) completed a PSG, and of those, 32 (64%) completed both a PSG with comparison RHO. There were more white infants in both groups than other races and ethnicities. Bland–Altman analysis showed a strong agreement of oxygen saturation time below 90% SpO2 between PSG and RHO results (slope = 1.014, p = 0.24). Results agreed in 96% of cases. Conclusion RHO is a safe and effective alternative to PSG to assist in determination of discontinuing HOT in infants with BPD without other risks for sleep‐disordered breathing.

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The use of overnight oximetry in neonates: A literature review

Cited by 9 publications

References 40 publications

Comparison of 12‐hour and 24‐hour oximetry recordings in preterm infants

Comparison of 12‐hour and 24‐hour oximetry recordings in preterm infants

Frequent hypoxemia found in infants with bronchopulmonary dysplasia after weaning home oxygen

Does recorded oximetry utilizing a consensus‐based algorithm compare to polysomnography in discontinuing home oxygen therapy in premature infants?

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