RT Journal Article
SR Electronic
T1 Using intermittent pulse oximetry to guide neonatal oxygen therapy in a low-resource context
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 316
OP 321
DO 10.1136/archdischild-2019-317630
VO 105
IS 3
A1 Walker, Patrick James Berkeley
A1 Bakare, Ayobami Adebayo
A1 Ayede, Adejumoke Idowu
A1 Oluwafemi, Rosena Olubanke
A1 Olubosede, Omolayo Adebukola
A1 Olafimihan, Iyabo Victoria
A1 Tan, Kenneth
A1 Duke, Trevor
A1 Falade, Adegoke Gbadegesin
A1 Graham, Hamish
YR 2020
UL http://fn.bmj.com/content/105/3/316.abstract
AB Objective To evaluate the effectiveness of intermittent pulse oximetry in guiding oxygen therapy in neonates in a low-resource setting.Design and setting Prospective validation study at three hospitals in southwest Nigeria. We performed concealed continuous pulse oximetry on participants to evaluate intermittent SpO2 monitoring.Patients We recruited all preterm or low birthweight neonates, and all term neonates who required oxygen therapy, who were admitted to the neonatal ward(s) of the study hospitals during the study period.Main outcome measures Proportion of time preterm/low birthweight neonates on oxygen spent within, above and below the target SpO2 range of 90%–95%; and the proportion of time term neonates and neonates not on oxygen spent within and below the target range of 90%–100%.Results Preterm/low birthweight neonates receiving oxygen therapy (group A) spent 15.7% (95% CI 13.3 to 18.9) of time in the target SpO2 range of 90%–95%. They spent 75.0% (63.6–81.1) of time above 95%, and 2.7% (1.7–5.6) of time below 85%. Term neonates and all neonates not receiving oxygen (group B) spent 97.3% (95% CI 96.4 to 98.6) of time within the target range of 90%–100%, and 0.9% (0.3–1.4) of time below 85%. Guidelines recommended SpO2 monitoring 3 times per day for all patients, however neonates in groups A and B were monitored an average of 4.7 and 5.3 times per day, respectively.Conclusions To better maintain SpO2 within the target range, preterm/low birthweight neonates on oxygen should have their SpO2 monitored more frequently than the current 4.7 times per day. In all other neonates, however, monitoring SpO2 5.3 times per day appears suitable.