Awake daytime oximetry measurements in the management of infants with chronic lung disease

Objective: To assess the value of 1-h daytime awake oximetry as a means of weaning oxygen flows in infants with oxygen dependent chronic lung disease. Methods: A cohort study of oxygen dependent infants enrolled in a 3-month p eriod. One hour of awake oximetry data were compared with equal time period s defined within a polysomnographic study and at the same oxygen flow rate. Sensitivity results were derived from the decision to wean oxygen to a low er flow or air. Results: Twenty-two infants were enrolled and 27 studies were performed. Th e infants that could be weaned had an awake median of mean oxygen saturatio ns of 97% and spent 14% of the time less than or equal to 95% but only 2% l ess than or equal to 92%, while for those not weaned, the awake median of m ean oxygen saturations was 94% with 43% of their time less than or equal to 95% and 26.8% less than or equal to 92% saturation. Conclusions: Daytime oximetry can predict the outcome of polysomnography wi th a sensitivity of 100% and a specificity of 65%, and could be used to wea n oxygen or as a screening tool for polysomnographic studies in infants wit h chronic lung disease provided there are reasonably long periods of monito ring and mean oxygen saturations above 95%.