Oxygen saturation ranges for healthy newborns within 24 hours at 1800 m

Morgan, Melissa C.; Maina, Beth; Waiyego, Mary; Mutinda, Catherine; Aluvaala, Jalemba; Maina, Michuki; English, Mike

doi:10.1136/archdischild-2016-311813

Cited by 17 publications

(14 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We recognise that normal saturations can be lower for neonates immediately after birth and can vary by probe location (pre-ductal versus post-ductal). However, studies in similar settings have reported that more than 95% of SpO 2 readings are ≥90% even in the first hours of life (irrespective of probe location) [60].…”

Section: Discussionmentioning

confidence: 97%

Hypoxaemia in hospitalised children and neonates: A prospective cohort study in Nigerian secondary-level hospitals

et al. 2019

View full text Add to dashboard Cite

a b s t r a c tBackground: Hypoxaemia is a common complication of pneumonia and a major risk factor for death, but less is known about hypoxaemia in other common conditions. We evaluated the epidemiology of hypoxaemia and oxygen use in hospitalised neonates and children in Nigeria. Methods:We conducted a prospective cohort study among neonates and children ( < 15 years of age) admitted to 12 secondary-level hospitals in southwest Nigeria (November 2015-November 2017) using data extracted from clinical records (documented during routine care). We report summary statistics on hypoxaemia prevalence, oxygen use, and clinical predictors of hypoxaemia. We used generalised linear mixed-models to calculate relative odds of death (hypoxaemia vs not). Findings: Participating hospitals admitted 23,926 neonates and children during the study period. Pooled hypoxaemia prevalence was 22.2% (95%CI 21.2-23.2) for neonates and 10.2% (9.7-10.8) for children. Hypoxaemia was common among children with acute lower respiratory infection (28.0%), asthma (20.4%), meningitis/encephalitis (17.4%), malnutrition (16.3%), acute febrile encephalopathy (15.4%), sepsis (8.7%) and malaria (8.5%), and neonates with neonatal encephalopathy (33.4%), prematurity (26.6%), and sepsis (21.0%). Hypoxaemia increased the adjusted odds of death 6-fold in neonates and 7-fold in children. Clinical signs predicted hypoxaemia poorly, and their predictive ability varied across ages and conditions. Hypoxaemic children received oxygen for a median of 2-3 days, consuming ∼3500 L of oxygen per admission. Interpretation: Hypoxaemia is common in respiratory and non-respiratory acute childhood illness and increases the risk of death substantially. Given the limitations of clinical signs, pulse oximetry is an essential tool for detecting hypoxaemia, and should be part of the routine assessment of all hospitalised neonates and children.

show abstract

Section: Discussionmentioning

confidence: 97%

Hypoxaemia in hospitalised children and neonates: A prospective cohort study in Nigerian secondary-level hospitals

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Gestational age was based on last menstrual period (LMP), and Ballard examination was conducted when LMP was unknown or incongruent with appearance (ultrasonography is rarely available). We determined the prevalence of hypoxaemia, calculated as the number of neonates with pre-or post-ductal SpO 2 below the previously defined local threshold of 89% for healthy term and preterm neonates within 24 h at 1800 m, 31 divided by the total number of neonates admitted during the study period. We determined odds ratios for hypoxaemia and all-cause inpatient death by gestational age, birthweight and clinical risk factors and signs.…”

Section: Methodsmentioning

confidence: 99%

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Morgan

Maina

Waiyego

et al. 2017

J Paediatrics Child Health

Self Cite

View full text Add to dashboard Cite

AimThere are 2.7 million neonatal deaths annually, 75% of which occur in sub‐Saharan Africa and South Asia. Effective treatment of hypoxaemia through tailored oxygen therapy could reduce neonatal mortality and prevent oxygen toxicity.MethodsWe undertook a two‐part prospective study of neonates admitted to a neonatal unit in Nairobi, Kenya, between January and December 2015. We determined the prevalence of hypoxaemia and explored associations of clinical risk factors and signs of respiratory distress with hypoxaemia and mortality. After staff training on oxygen saturation (SpO2) target ranges, we enrolled a consecutive sample of neonates admitted for oxygen and measured SpO2 at 0, 6, 12, 18 and 24 h post‐admission. We estimated the proportion of neonates outside the target range (≥34 weeks: ≥92%; <34 weeks: 89–93%) with 95% confidence intervals (CIs).ResultsA total of 477 neonates were enrolled. Prevalence of hypoxaemia was 29.2%. Retractions (odds ratio (OR) 2.83, 95% CI 1.47–5.47), nasal flaring (OR 2.68, 95% CI 1.51–4.75), and grunting (OR 2.47, 95% CI 1.27–4.80) were significantly associated with hypoxaemia. Nasal flaring (OR 2.85, 95% CI 1.25–6.54), and hypoxaemia (OR 3.06, 95% CI 1.54–6.07) were significantly associated with mortality; 64% of neonates receiving oxygen were out of range at ≥2 time points and 43% at ≥3 time points.ConclusionThere is a high prevalence of hypoxaemia at admission and a strong association between hypoxaemia and mortality in this Kenyan neonatal unit. Many neonates had out of range SpO2 values while receiving oxygen. Further research is needed to test strategies aimed at improving the accuracy of oxygen provision in low‐resource settings.

show abstract

“…Ravert et al ( 21) compared SpO 2 in term infants and premature infants born at altitudes of 1,371-2,484 meters, and found that preterm infants tend to have higher SpO 2 ; however, the authors did not specify the exact gestational age. But, multiple studies (16,22) on healthy late preterm infants and term infants showed that there was no difference in SpO 2 between them after birth.…”

Section: Discussionmentioning

confidence: 99%

“…In this review, we only included studies reporting SpO 2 levels during the period from 24 h after birth to before discharge. Studies reporting SpO 2 within 24 h of birth were excluded because SpO 2 levels fluctuate during this period ( 16 ). In a study conducted at sea level on healthy neonates, Toth et al found that the mean post-ductal SpO 2 was 67% at 2 min after birth, but rose gradually over 14 min to reach 95% ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Reference Interval for Pulse Oxygen Saturation in Neonates at Different Altitudes: A Systematic Review

Wang

Zhang

et al. 2021

Front. Pediatr.

View full text Add to dashboard Cite

Introduction: The reference interval for pulse oxygen saturation (SpO2) in neonates born at high altitudes has not been defined to date. The purpose of this study was to systematically review published studies and determine the reference interval of SpO2 in neonates at different altitudes.Methods: Databases of PubMed, Embase, Cochrane Library, Clinicaltrials.Gov, Chinese National Knowledge Infrastructure Database, Wanfang Database, Chinese Science Technology Journals Database, and Chinese Clinical Trial Registry were searched for studies reporting SpO2 in healthy neonates at different altitudes. Retrieval time was from inception of the database to August 16, 2021. The Agency for Healthcare Research and Quality checklist was used to evaluate the quality of studies. Python v3.8 was used to analyze the data. This systematic review was drafted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Results: Seven cross-sectional studies, published between 1991 and 2020, were identified. They were from US, Mexico, Israel, Ecuador, and China. Three studies were rated as high quality and four as moderate quality. The mean SpO2 (with standard deviation or standard error) of neonates born in 40 different altitudes (ranging from 25 meters to 3,100 meters) were obtained. The prediction equation for calculation of the lower limit of the reference interval was established, and the reference intervals for SpO2 at different altitudes were determined.Conclusions: In healthy neonates, the lower limit of the reference interval of SpO2 decreases with increase in altitude. High-quality prospective studies are need to confirm our findings.

show abstract

Oxygen saturation ranges for healthy newborns within 24 hours at 1800 m

Cited by 17 publications

References 5 publications

Hypoxaemia in hospitalised children and neonates: A prospective cohort study in Nigerian secondary-level hospitals

Hypoxaemia in hospitalised children and neonates: A prospective cohort study in Nigerian secondary-level hospitals

Pulse oximetry values of neonates admitted for care and receiving routine oxygen therapy at a resource‐limited hospital in Kenya

Reference Interval for Pulse Oxygen Saturation in Neonates at Different Altitudes: A Systematic Review

Contact Info

Product

Resources

About