Pulse Oximetry — An Alternative to Transcutaneous PO₂ in Sick Newborns

Abstract

Modern day intensive care for sick newborn infants includes continuous monitoring of oxygen as a routine. This routine stems from our concerns regarding hyperoxemia and its probable role in retinopathy of prematurity and hypoxemia and its role in CNS damage, pulmonary vasoconstriction and possibly in retinopathy of prematurity. Transcutaneous PO₂ (tcPO₂) monitoring, the most widely used method in the 1970s and early 1980s, has provided an excellent detector of fluctuations in PO₂ that cannot be detected by intermittent sampling of arterial blood. It has permitted rapid detection of hypoxemia associated with apnea, hypoventilation, or procedures. However, transcutaneous monitoring has limitations, including frequent calibration periods and a heated electrode, which causes first, and occasionally, second degree burns and which requires frequent site changes. Furthermore, unpredictable gradients have been reported between skin and arterial PO₂ values in older infants and in infants with bronchopulmonary dysplasia.

Modified in part from manuscript in press, Pediatrics, 1986.