Pediatrics and Neonatology (Dec 2014)

Reevaluating Reference Ranges of Oxygen Saturation for Healthy Full-term Neonates Using Pulse Oximetry

  • Ying-Chun Lu,
  • Chih-Chien Wang,
  • Chuen-Ming Lee,
  • Kwei-Shuai Hwang,
  • Yi-Ming Hua,
  • Yeong-Seng Yuh,
  • Yu-Lung Chiu,
  • Wan-Fu Hsu,
  • Ya-Ling Chou,
  • Shao-Wei Huang,
  • Yih-Jing Lee,
  • Hueng-Chuen Fan

DOI
https://doi.org/10.1016/j.pedneo.2014.02.004
Journal volume & issue
Vol. 55, no. 6
pp. 459 – 465

Abstract

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We compared our clinical experience with currently available reference oxygen saturation level (SpO2) values from the American Academy of Pediatrics/American Heart Association (AAP/AHA) neonatal resuscitation program guidelines. Methods: We enrolled 145 healthy full-term neonates; infants showing respiratory distress and those with serious congenital anomalies were excluded. SpO2 values at every 1 minute until 10 minutes after birth were measured and recorded. Infants were classified into the cesarean section (CS) and normal spontaneous delivery (NSD) groups for evaluating differences. The 10th percentiles of SpO2 at each minute were used as the lower limits of normal oxygen saturation, and these were compared with the lowest target values recommended in the AAP/AHA guidelines. Results: Overall, 130 vigorous full-term neonates (median gestational age: 38 5/7 weeks; body weight at birth: 2405–3960 g) were analyzed. The median SpO2 were 67% and 89% at the 1st and 4th minute, respectively. On average, SpO2 values reached >90% at the 5th minute. No statistical differences were noted in the SpO2 values between the CS and NSD groups after 5 minutes; however, a trend of higher SpO2 was observed in the NSD group. We noted a gradually increasing trend for SpO2 values over time, similar to that noted in the AAP/AHA guidelines. However, SpO2 values at the 10th percentiles of each minute within the first 5 minutes in our study were equal to or significantly lower than those in the AAP/AHA guidelines; moreover, at the 10th minute, SpO2 values at the 10th percentiles were significantly higher than those in the guidelines. Conclusion: The delivery modes did not affect the SpO2 values of full-term healthy neonates. Discrepancies in SpO2 changes in full-term neonates not requiring resuscitation between this study and the AAP/AHA guidelines were significant. SpO2 ranges for each time point within the first 10 minutes after birth should therefore be reevaluated locally.

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