Oxygen Saturation Monitoring in Neonatal Period
Oxygen (O2) is a potent drug that is often used inappropriately in the clinical environment. Its administration needs to be improved in neonatal care. Healthcare providers never induce hypoxemia, and the same is not true for hyperoxemia. Clinical signs (cyanosis and tongue color) are of no value to detect hypoxemia and hyperoxemia. Pulse oximetry (SpO2) is the most important method for monitoring O2 saturation. The hazards of hyperoxemia and hyperoxia should be avoided or minimized. Undesired effects of maternal and fetal oxidative stress and short- and long-term O2 therapy involve every organ system and many genes. The SpO2 in normal newborns and in those who are treated with CPAP or assisted ventilation breathing room air (FiO2 0.21) is 95–100%. The intention to “target SpO2” in infants breathing supplemental O2 should not include values associated with potential hyperoxia nor possible hypoxia and also must aim to avoid recurring periods of hypoxemia-hyperoxemia-reperfusion. It is impossible to maintain newborn infants within narrow SpO2 target ranges all the time. Choosing wider intermediate SpO2 ranges for treatment allows for easier care and better compliance, and such ranges have been associated with a decreased rate of severe ROP, without an increased morbidity or mortality.
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