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.
Adams
J M
JM
Department of Pediatrics, Baylor College of Medicine and Biomedical Engineering Department, Texas Children's Hospital.
Murfin
K
K
Gullikson
M
M
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