PEDIATRICS Vol. 84 No. 2 August 1989, pp. 226-230
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bucher, H.-U.
Right arrow Articles by Duc, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bucher, H.-U.
Right arrow Articles by Duc, G.

Hyperoxemia in Newborn Infants: Detection by Pulse Oximetry

Hans-Ulrich Bucher MD1, Sergio Fanconi MD1, Peter Baeckert MD1, and Gabriel Duc MD1

1 The Division of Neonatology, Department of Obstetrics and Gynecology, and from the Department of Pediatrics, University of Zurich, Switzerland

Pulse oximetry has been proposed as a non-invasive continuous method for transcutaneous monitoring of arterial oxygen saturation of hemoglobin (tcSO2) in the newborn infant. The reliability of this technique in detecting hyperoxemia is controversial, because small changes in saturation greater than 90% are associated with relatively large changes in arterial oxygen tension (PaO2). The purpose of this study was to assess the reliability of pulse oximetry using an alarm limit of 95% tcSO2 in detecting hyperoxemia (defined as PaO2 greater than 90 mm Hg) and to examine the effect of varying the alarm limit on reliability. Two types of pulse oximeter were studied alternately in 50 newborn infants who were mechanically ventilated with indwelling arterial lines. Three arterial blood samples were drawn from every infant during routine increase of inspired oxygen before intratracheal suction, and PaO2 was compared with tcSO2. The Nellcor N-100 pulse oximeter identified all 26 hyperoxemic instances correctly (sensitivity 100%) and alarmed falsely in 25 of 49 nonhyperoxemic instances (specificity 49%). The Ohmeda Biox 3700 pulse oximeter detected 13 of 35 hyperoxemic instances (sensitivity 37%) and alarmed falsely in 7 of 40 nonhyperoxemic instances (specificity 83%). The optimal alarm limit, defined as a sensitivity of 95% or more associated with maximal specificity, was determined for Nellcor N-100 at 96% tcSO2 (specificity 38%) and for Ohmeda Biox 3700 at 89% tcSO2 (specificity 52%). It was concluded that pulse oximeters can be highly sensitive in detecting hyperoxemia provided that type-specific alarm limits are set and a low specificity is accepted.

Key Words: pulse oximetry • monitoring • newborn • oxygen saturation • hyperoxemia

Submitted on April 1, 1988
Accepted on August 24, 1988




This article has been cited by other articles:


Home page
 PediatricsHome page
A. Castillo, A. Sola, H. Baquero, F. Neira, R. Alvis, R. Deulofeut, and A. Critz
Pulse Oxygen Saturation Levels and Arterial Oxygen Tension Values in Newborns Receiving Oxygen Therapy in the Neonatal Intensive Care Unit: Is 85% to 93% an Acceptable Range?
Pediatrics, May 1, 2008; 121(5): 882 - 889.
[Abstract] [Full Text] [PDF]

Home page
 Am J Crit CareHome page
S.-Y. P. K. Shiao and C.-N. Ou
Validation of Oxygen Saturation Monitoring in Neonates
Am. J. Crit. Care., March 1, 2007; 16(2): 168 - 178.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. P. Ford, M. K. Leick-Rude, K. A. Meinert, B. Anderson, M. B. Sheehan, B. M. Haney, S. R. Leeks, S. D. Simon, and J. K. Jackson
Overcoming Barriers to Oxygen Saturation Targeting
Pediatrics, November 1, 2006; 118(Supplement_2): S177 - S186.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
V. Bernet-Buettiker, M. J. Ugarte, B. Frey, M. I. Hug, O. Baenziger, and M. Weiss
Evaluation of a New Combined Transcutaneous Measurement of PCO2/Pulse Oximetry Oxygen Saturation Ear Sensor in Newborn Patients
Pediatrics, January 1, 2005; 115(1): e64 - e68.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
L. M. Askie and W. Tin
The Use of Oxygen in Neonatal Medicine: Half a Century of Uncertainty
NeoReviews, December 1, 2003; 4(12): e340 - 348.
[Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
B Bohnhorst, C S Peter, and C F Poets
Detection of hyperoxaemia in neonates: data from three new pulse oximeters
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2002; 87(3): F217 - 219.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
W Tin, D W A Milligan, P Pennefather, and E Hey
Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation
Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2001; 84(2): 106F - 110.
[Abstract] [Full Text]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
J. R Skinner, S. Hunter, C. F Poets, D. W A Milligan, D. Southall, and E. N Hey
Haemodynamic effects of altering arterial oxygen saturation in preterm infants with respiratory failure
Arch. Dis. Child. Fetal Neonatal Ed., March 1, 1999; 80(2): 81F - 87.
[Abstract] [Full Text]