PULSE OXIMETRY IN VENTILATED PRETERM NEWBORNS - RELIABILITY OF DETECTION OF HYPEROXAEMIA AND HYPOXEMIA, AND FEASIBILITY OF ALARM SETTINGS

The aim of our study was to evaluate the reliability of pulse oximetry in detecting both hyper- and hypoxaemic states and to create clinical ly feasible alarm limits. A total of 792 readings of a pulse oximeter and corresponding values of arterial oxygen tension from 146 (79M, 67F ) artificially ventilated preterm newborns with indwelling umbilical a rtery catheters were compared. Predictive value analysis of pulse oxim eter readings related to arterial oxygen tension confirmed the ability of the pulse oximeter to identify both hypoxaemia and hyperoxaemia. H owever, a clinically feasible and safe range of alarm limits for maint enance of arterial oxygen tension of 40-90 mmHg (5.3-12 kPa) could onl y be established at a sensitivity level less than 0.9. At a level of 0 .85, the alarm range on the pulse oximeter was 92.5-95%. Based on thes e findings, we are concerned about using pulse oximetry as the sole me ans of oxygen monitoring for preterm infants receiving supplementary o xygen. A combination of the pulse oximetry with other methods of blood -gas monitoring seems mandatory.