Detection of hypoxemia and hyperoxemia by pulse oximetry in neonates and children
Keywords:
blood gas analysis, pulse oximetry, oxygen saturation, hypoxemia, hyperoxemia, diagnostic test
Abstract
Objective To assess the validity of pulse oximetry for detectinghypoxemia and hyperoxemia in neonates and children.
Methods This was a diagnostic test study conducted in Neonatal
Intensive Care Unit (NICU). The subjects of the study were
neonates of 0-28 days and children aged one month to 14 years
in Pediatric Intensive Care Unit (PICU) of Sardjito Hospital.
Hypoxemia and hyperoxemia were obtained by using NellcorR
pulse oximetry, at the same time as blood gas analysis was obtained
as a gold standard.
Results There were 240 neonates and 268 children enrolled in
this study. Pulse oximetry test with cut-off point 91% (neonates)
and 90% (children) for detecting hypoxemia had sensitivity of
81% and 80%, specificity of 79% and 95% positive predictive
value of 54% and 82% negative predictive value of93% and 93%
positive likelihood ratio of 3. 79 and 14.20 and negative likelihood
ratio of0.25 and 0.24. Pulse oximetry test with cut-off point 95%
(neonates) and 97% (children) for detecting hyperoxemia had
sensitivity of 7 8% and 81% specificity of 66% and 79%, positive
predictive value of77% and 76% negative predictive value of 66%
and 83% positive likelihood ratio of 2.26 and 3.84 and negative
likelihood ratio of 0.34 and 0.24.
Conclusion Pulse oximetry has a fairly good validity in detecting
hypoxemia in neonates and children and in detecting hyperoxemia
in children to however, it is not good enough to be used to detect
hyperoxemia in neonates.
References
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need to know to interprete arterial blood Gases. 2nd ed.
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8. Razi E, Akbari H. A comparison of arterial oxygen saturation
measured both by pulse oximeter and arterial blood gas
analyzer in hypoxemic and non-hypoxemic pulmonary
diseases. Turkish Respiratory Journal. 2006;7(2):43-6.
9. Schutz SL. Oxygen saturation monitoring by pulse oximetry.
In: American association of critical care nurses. AACN
Procedure manual for critical care. Saint Louis: Mosby, 2001;
p. 77-82.
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with pneumonia and its clinical predictors. Indian J Pediatr.
2006;73(9): 777-81.
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study of blood gas and acid base parameters of capillary with
arterial blood samples. Indian J Anaesth. 2004;48(6): 469-
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of Pediatrics committee. Text book of neonatal resuscitation.
5th ed. Washington: American Academy of Pediatrics, 2006;
p. 1-17.
2. Begin A V. Value of capillary blood gas analysis in the
management of acute respiratory distress. Am Rev Respir
Dis. 1975;112(6):879-81.
3. Durand DJ. Interpretation of blood gases. In : Sinha SK,
Donn SM, editor. Manual of neonatal respiratory care. New
York: Futura Publishing Company, 2000; p. 57-60.
4. Escalante KR, Tantalean DJ. Capillary blood gas in a pediatric
intensive care unit. Am J Dis Child. 1990; 144 (22): 168-72.
5. Gupta R, Yoxall CW, Subedhar N, Shaw NJ. Individualised
pulse oximetry limits in neonatal intensive care. Arch Dis Child
Fetal Neonatal. 1999;81:194-6.
6. Kamat V. Pulse oximetry. Indian J Anaesth. 2002;46
(4):261-8.
7. Martin L. Pulse oximetry. In: Percy P, editor. All you really
need to know to interprete arterial blood Gases. 2nd ed.
Philadelphia : Lippincott Wiklliams & Wilkins, 1999; p.
93-101.
8. Razi E, Akbari H. A comparison of arterial oxygen saturation
measured both by pulse oximeter and arterial blood gas
analyzer in hypoxemic and non-hypoxemic pulmonary
diseases. Turkish Respiratory Journal. 2006;7(2):43-6.
9. Schutz SL. Oxygen saturation monitoring by pulse oximetry.
In: American association of critical care nurses. AACN
Procedure manual for critical care. Saint Louis: Mosby, 2001;
p. 77-82.
10. Sudha B, Kant AR, Kumar GC. Hypoxemia in children
with pneumonia and its clinical predictors. Indian J Pediatr.
2006;73(9): 777-81.
11. Ugramurthy S, Rathna, Naik SD, Kurtkoti SS. Comparative
study of blood gas and acid base parameters of capillary with
arterial blood samples. Indian J Anaesth. 2004;48(6): 469-
71.
12. Yanda S, Lubis M, Yusroh Y. Comparison of oxygen saturation
measured by pulse oximetry and arterial blood gas analysis in
neonates. Paediatr Indones. 2003;43:211-5.
Published
2016-09-15
How to Cite
1.
Ritonga SM, Haksari E, Suryantoro P. Detection of hypoxemia and hyperoxemia by pulse oximetry in neonates and children. PI [Internet]. 15Sep.2016 [cited 23Dec.2024];48(6):346-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/627
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Received 2016-09-14
Accepted 2016-09-14
Published 2016-09-15
Accepted 2016-09-14
Published 2016-09-15
