Reference values of nocturnal oxygenation for use in outpatient oxygen weaning protocols in premature infants

Rhein, Lawrence; Simoneau, Tregony; Davis, J. A.; Correia, Catherine E.; Ferrari, Dan; Monuteaux, Michael C.; Gregory, MaryLucia

doi:10.1002/ppul.21562

Cited by 38 publications

(51 citation statements)

References 29 publications

(61 reference statements)

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“…Con respecto a trastornos respiratorios del sueño en recién nacidos -d. Zenteno et al mediadas cada 2 segundos, pues permite mejorar la precisión de resultados, posee una menor alteración en situaciones de mala perfusión, ruido y movimiento. También ha demostrado disminuir porcentaje de falsas alarmas, fenómenos no percibidos y artefactos 12,13,14,15,16,17,18 . El análisis de correlación indicó que los paráme-tros de saturación muestran asociación de moderada a fuerte entre la SpO2C y la PG.…”

Section: Resultsunclassified

Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía

Zenteno

Bancalari

Navarro

et al. 2017

Rev. chil. pediatr.

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Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía ResumenIntroducción: La Saturometría Nocturna Continua (SpO2C), es utilizada en Unidades de Neonatología para detección de eventos de hipoxemia en Recién Nacidos (RN) con episodios de apneas. La Poligrafía (PG) presenta un número mayor de canales de medición. El objetivo fue evaluar el rendimiento diagnóstico de la SpO2C respecto a la Poligrafía en RN con sospecha de apneas. Pacientes y Método: Se analizaron retrospectivamente resultados de SpO2C y PG realizadas en forma simultáneas en RN con sospecha de apneas, en un periodo de tres años. Se utilizó un saturómetro Masimo Radical-7® con 2 canales y un polígrafo Apnea Link Plus® con 5 canales de registro simultáneos. Se consideró PG alterada: índice de desaturaciones bajo 80% por hora ≥ a 1 y/o número de desaturaciones bajo 80% ≥ 20 segundos mayor a uno en todo el registro validado y/o índice de apnea hipoapnea ≥ a 1 evento por hora. Paralelamente, se definió SpO2C alterada cuando uno o ambos de los criterios de saturometria bajo 80%, estaban alterados. Se calcularon valores de sensibilidad, especificidad, valores predictivos y Likelihood Ratio (LLR) para la SpO2C. Los resultados se expresaron en valor absoluto, con 95% de intervalo de confianza. Resultados: Se realizaron 40 SpO2C y PG simultáneos; un 80% (32/40) de ellos fueron RN prematuros, 60% (24/40) varones. Un 38% (15/40) de las SpO2C y un 15% (6/40) de las PG resultaron alteradas (p < 0,05). La SpO2C presenta una Sensibilidad 100%, Especificidad 74%, El VPP 40%, VPN 100%, LLR + 3,78 y LLR-0. Conclusión: En los RN estudiados, la SpO2C posee un alto valor diagnóstico, sin embargo, puede presentar falsos positivos; por lo cual se sugiere utilizar como método de tamizaje y realizar confirmación diagnóstica con otro examen de sueño, como la PG. 760EXPERIEnCIA CLÍnICA trastornos respiratorios del sueño en recién nacidos -d. Zenteno et al Keywords:Continuous nocturnal saturometry, polygraphy, newborns, apneas Abstract Introduction: Night Continuous Saturometry (CSO 2 ) is used in Neonatal Units to detect events of hypoxemia in Newborns (NB) with apnea episodes. Polygraphy (PG) has a larger number of measuring channels. Our goal was to evaluate the diagnostic performance of CSO 2 compared to Polygraphy in NB with suspected sleep apneas. Patients and Method: Results of CSO 2 and PG performed simultaneously in RN with suspected apneas were retrospectively analyzed over a three-year period. A 2-channel Masimo Radical-7® pulse oximeter and an Apnea Link Plus® polygraph with 5 simultaneous recording channels were used. Altered PG was defined as: desaturation index under 80% per hour ≥ 1 and/or number of desaturations under 80% ≥ 20 seconds greater than one in the whole validated registry and/or hypoapnea apnea index ≥ 1 event per hour. In parallel, altered SpO 2 C was defined when one or both of the 80% saturation criteria were altered. Sensitivity, specificity, pr...

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Section: Resultsunclassified

Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía

Zenteno

Bancalari

Navarro

et al. 2017

Rev. chil. pediatr.

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“…Some paediatric respiratory specialists in our study were hesitant to rely on the ODI generated in oximetry reports as it may include desaturation events (e.g. SpO 2 100–95%) of unknown significance and a common occurrence in healthy infants . However, the American Academy of Sleep Medicine respiratory rules for children uses ODI 3% (even if SpO 2 nadir is >95%) and would score central apnoeas or hypopnoeas followed by a desaturation from SpO 2 100 to 95% on PSG …”

Section: Discussionmentioning

confidence: 99%

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

Wong

Chung

Chawla

2019

J Paediatrics Child Health

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Aim The aims of this study are: (i) to survey the knowledge of paediatric clinicians using overnight continuous pulse oximetry data to guide management of infants with chronic neonatal lung disease (CNLD); (ii) to assess the ability of paediatric clinicians to interpret overnight continuous pulse oximetry data; and (iii) to describe the overnight oximetry interpretation practices of paediatric respiratory specialists. Methods Paediatric clinicians from three tertiary teaching hospitals completed an anonymous survey regarding overnight continuous pulse oximetry in chronic neonatal lung disease. Using a modified Delphi technique, paediatric respiratory specialists participated in a concordance exercise and discussions to establish consensus interpretations for 25 oximetry studies. Paediatric clinicians were invited to complete the same exercise as a comparison. Results Self‐rated knowledge from 74 surveyed clinicians was proportional to clinical experience. Twenty paediatric clinicians and nine paediatric respiratory specialists completed the oximetry exercise with scores of 64% (κ = 0.25) and 80% (κ = 0.45), respectively. Individual parameters like a mean peripheral arterial haemoglobin saturation (SpO2) below 93% and percentage time spent below SpO2 93% correlated poorly with the consensus interpretations. Paediatric respiratory specialists instead relied on visual analysis of SpO2 waveforms, utilising the frequency and depth of desaturations to guide management. Conclusion Interpretation of overnight oximetry data is variable amongst both paediatric clinicians and respiratory specialists. This likely reflects inadequate evidence defining clinically significant intermittent hypoxaemia, whether in terms of desaturation duration, frequency or nadir.

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“…The characteristics of the included studies are summarised in Table . Of the 16 studies, 8 were described as prospective longitudinal cohort studies.…”

Section: Summary Of Findings and Discussionmentioning

confidence: 99%

“…Seven studies included a preterm population . Two studies recruited two age groups, >37 weeks and <37 weeks, to define reference ranges in these two groups . The median post‐natal age in a number of studies was 14 days for the first oximeter trace.…”

Section: Summary Of Findings and Discussionmentioning

confidence: 99%

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The use of overnight oximetry in neonates: A literature review

Flint

Davies

2018

J Paediatrics Child Health

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There is much debate between neonatologists and paediatricians about appropriate oxygen saturation targets for babies with chronic neonatal lung disease (CNLD). Overnight oximetry is used to guide the fraction of inspired oxygen to use. We did this literature review to examine the current literature on the use of overnight oximetry in term infants, preterm infants and babies with CNLD (especially relevant to ex-preterm babies with CNLD going home on oxygen). We reviewed the literature from January 1990 to October 2017 by searching the following databases: Cochrane Central Register of Controlled Trials, The Joanna Briggs Institute, CINAHL, MEDLINE, Scopus, EMBASE, ProQuest and Science Direct. Sixteen articles were included in the review. The literature available on overnight oximetry in neonates is limited, it is not contemporary, and it reports studies that did not use oximeters with modern software for data collection and analysis. It is imperative that reference ranges be defined for overnight oximetry parameters so that babies are not inadvertently administered inappropriate amounts of oxygen.

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Reference values of nocturnal oxygenation for use in outpatient oxygen weaning protocols in premature infants

Cited by 38 publications

References 29 publications

Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía

Diagnóstico de los trastornos respiratorios del sueño en recién nacidos con sospecha de apneas: comparación entre la saturometría nocturna y la poligrafía

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

The use of overnight oximetry in neonates: A literature review

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