Editor—I read the descriptive study of Tinet al 1 with considerable interest. In essence it challenges two sacred cows of neonatal intensive care, whether intra-arterial monitoring is necessary, and what is the appropriate PaO2 at which to nurse critically ill babies.

arterial monitoring

They do not give us accurate details of arterial catheter use. There is a hint that they are used for the first few days before resorting to SpO2 and capillary measurements. Nor do they tell us what analgesia is used for multiple capillary samples.

A fundamental principle of neonatal intensive care is minimal handling, and indwelling arterial catheters allow all samples to be taken with no or minimal disturbance, and if the catheters are umbilical, they can also be used safely for virtually all infusions including TPN. Furthermore, as opposed to oscillometric techniques, they allow accurate blood pressure recordings.

Surprisingly, …