Detection of hyperoxemia in neonates by a new pulse oximeter.
OBJECTIVE
We studied the ability of a new pulse oximeter to detect hyperoxemia in neonates.


METHODS
One hundred arterial blood samples were obtained from umbilical artery catheters of 41 acutely ill neonates (birth weight 560-4100 grams) while SpO2 was simultaneously measured at a postductal site.  The relationship between PaO2 and SpO2 was examined and expressed on a matrix.  Hyperoxemia was defined as PaO2 greater than 90 mm Hg and upper alarm limit for pulse oximetry was set at 95%.  The incidence of true hyperoxemia (PaO2 greater than 90 mm Hg, SpO2 greater than 95%) was determined and sensitivity and specificity for detection of hyperoxemia by the SpaceLabs device was calculated.


RESULTS
Hyperoxemia was detected in eighteen samples with sixteen having SpO2 greater than 95% (89% sensitivity).  In 82 samples having a PaO2 value less than or equal to 90 mm Hg, 53 were associated with SpO2 less than or equal to 95% (65% specificity).  Among 55 samples with SpO2 less than or equal to 95% hyperoxemia occurred in only 2 (3.6%).  Sensitivity of 95% would have been achieved with upper alarm limit set at 94%.


CONCLUSIONS
The new pulse oximeter evaluated detected 89% of episodes of hyperoxemia with upper alarm limits set at 95% and 95% of episodes if upper limit was set at 94%.  As previously reported, both individual device algorithms and upper alarm limits chosen determine ability of pulse oximeters to detect hyperoxemia.
Department of Pediatrics, Baylor College of Medicine and Biomedical Engineering Department, Texas Children's Hospital.
J M
JM
Adams
K
K
Murfin
M
M
Gullikson
D001784:Blood Gas Analysis / Q000295:instrumentation* / Q000379:methods; D005069:Evaluation Studies as Topic; D005319:Fetal Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D012680:Sensitivity and Specificity