Therapy and Monitoring
|Reviewed by Clinical Practice
- Supplemental oxygen must always be monitored.
- There are risks of too little or too much
- Preterm infants are at risk of
- Term infants are at risk of pulmonary
hypertension if hypoxaemic.
- Babies with chronic lung disease are at
risk of pulmonary vascular disease if hypoxic.
See the list
of related documents
Pulse Oximetry (SpO2)
- Any baby receiving oxygen therapy (except
chronic babies prior to discharge) should have continuous pulse oximeter
monitoring. These are very useful and easy to use.
- Accuracy is about ± 2%. The therapeutic range
is small. Remember the oxygen dissociation curve in interpreting the result.
to the Left
to the Right
Umbilical Artery Catheter
- Use in preference to peripheral in VLBW or
babies likely to have prolonged or difficult course.
- Use size 3.5 FG <1000 gms, 5 FG
- Preferably, use a high catheter position
(T6-T10) rather than the low position (L3-L4).
(Radial, Ulnar or Posterior Tibial)
- For Radial/Ulnar, check patency of other
artery by transillumination. (Allen test is unreliable.)
- Do not use if other artery is not patent.
- These are seldom necessary as oxygenation can
be determined by SpO2 and CO2 is often inaccurate with
a stab on an unsettled baby.
Transcutaneous Monitor (TcPO2 and
- These may be useful in complementing SpO2
monitoring, but are less reliable and more difficult to use.
Capillary Blood Gas
- This gives an indication of pH and PCO2
only and is not accurate.
- They are NOT useful for PO2
- Interpret results with caution.
- Check with an arterial blood gas if necessary.
- Interpret in the whole clinical context (i.e.
look at the baby).
- The result tells you that the true pH and PCO2
are probably no worse (well not much) than the capillary result.
- Do not repeat an imprecise and not very useful
test too often!
- This is dependent on the tissues need
(utilisation or uptake) and oxygen delivery.
- O2 delivery varies with blood flow
and O2 content, in turn a product of haemoglobin and saturation.