• Oxygenation and oxygen therapy must be closely monitored.
• Appropriate use is life saving but inappropriate use has dangers: i.e. high levels contributing to retinopathy of prematurity and low levels to pulmonary hypertension.
• In unwell infants, oxygen needs are continually changing and the nurse should vary the inspired oxygen concentration within these guidelines.

1. A cyanosed baby or one with a low saturation (SpO₂) should be given enough oxygen to become pink or saturated. It may be necessary to initiate other resuscitative procedures. Call medical staff for urgent assistance.
2. Babies receiving supplemental oxygen, or those likely to need it should be monitored by continuous pulse oximetry, (with the exception of babies close to being discharged on oxygen). If an arterial line is in situ, regular blood gases should be done. The frequency of these varies with the clinical situation (discuss this with medical staff or NS-ANPs).
3. The following are the recommended values. Any different range for an individual baby should be noted and signed on the nursing chart by Dr/NS-ANP.
   Click here to open the saturation targets
4. The nurse should alter the inspired oxygen to maintain the appropriate SpO₂/PaO₂. Remember that babies having apnoeas need to breath to oxygenate: it may be more appropriate to stimulate, bag or change ventilation settings rather than increase FiO₂.
5. If there is a sustained change in FiO₂ of more than 0.1 (10%), inform medical staff.
6. Be careful to decrease FiO₂ after a desaturation and avoid overshooting to high SpO₂ levels.
7. With Persistent Pulmonary Hypertension of the Newborn, FiO₂ is not to be decreased except on (signed) medical orders.
8. In some babies with complex cardiac conditions, a low saturation is desirable to help prevent ductus closure and excessive pulmonary blood flow.  In these babies, the medical staff will determine the desired saturation range.

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