• Supplemental oxygen must always be monitored.
• There are risks of too little or too much oxygen.
  • Preterm infants are at risk of ROP with high levels.
  • 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

Monitoring

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.

• 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 >1000 gms.
• Preferably, use a high catheter position (T6-T10) rather than the low position (L3-L4).

Peripheral Artery (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.

• These may be useful in complementing SpO₂ monitoring, but are less reliable and more difficult to use.

• This gives an indication of pH and PCO₂ only and is not accurate.
• They are NOT useful for PO₂ assessment.
• 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.