Objectives: We studied 22 neonates with gestational ages from 26 to 40 weeks to determine how accurately pulse oxygen saturation (SpO2) could predict arterial partial pressure of oxygen (PaO2) and how much time and effort would be required to achieve and maintain a desired SpO2 value.
Study design: SpO2 was maintained at 90%, 92%, 94%, 96%, and 98% by adjustment of FiO2. PaO2 was correlated with SpO2 by nonlinear mixed effects regression analysis.
Results: PaO2(y) correlated positively with SpO2(x): y = (0.03). e0.08(x). Variation of PaO2 increased from a range of +/- 10 Torr at SpO2 = 90% to +/- 28 Torr at SpO2 = 98%, principally as a result of decreasing hemoglobin-oxygen affinity, with no effect of advancing gestational age, subject temperature, pH, PaCO2. Considerable time (18 +/- 14 SD minutes) and effort (5 +/- 3 SD FiO2 adjustments/min were required to achieve and maintain a desired SpO2.
Conclusions: PaO2 varied broadly with SpO2 in a clinically acceptable range of SpO2 (90% to 98%), and the variability increased at higher SpO2 values. Considerable time and effort were required to achieve and maintain desired SpO2 values.