title: Awake and asleep oxygen saturations in infants with chronic neonatal lung disease.
abstract: OBJECTIVE
  There is uncertainty about the best method of withdrawing supplemental oxygen in babies with chronic neonatal lung disease (CNLD). Some authors advocate withdrawal of oxygen in the day, but continuing supplementation during sleep, based on early work suggesting that oxygen saturations are lower during sleep, which did not accord with our clinical impression. We re-examined the hypothesis that babies have lower saturations while asleep.
  
  
  METHODS
  We studied infants with CNLD during the day, while awake and asleep. We recorded video with simultaneous real-time capture of oxygen saturation (SpO2), heart rate and plethysmographic waveform from pulse oximetry. Behavioural state was scored using observation and video and classified as awake (feeding, active or quiet) or sleep.
  
  
  RESULTS
  Thirteen infants had analysable data, although one had strikingly lower SpO2 values while awake and was excluded from analysis. The infants had a median gestation of 26 weeks and were studied at a median (range) postmenstrual age of 66 (37-130) weeks, for 229 (89-330) min. Mean SpO2 was 97.6% during sleep and 97.0% awake (p=0.011).
  
  
  CONCLUSIONS
  Babies with CNLD have lower oxygen saturation while awake. There is no physiological justification for increasing oxygen during sleep, or withdrawing selectively during the daytime, although larger studies are needed to confirm this finding.
authors.affiliation: Department of Medicine, University of East Anglia, Norwich, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sykes
authors.forename: Ruth
authors.initials: R
authors.lastname: Kingshott
authors.forename: Robert
authors.initials: R
authors.lastname: Primhak
mesh_terms: D002908:Chronic Disease; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000097:blood* / Q000628:therapy; D008297:Male; D015588:Observer Variation; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D010102:Oxygen Inhalation Therapy; D010991:Plethysmography; D012890:Sleep / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology
chemical_list: D010100:Oxygen