Continuous Monitoring of Arterial Oxygen Tension in Infants: Four Years of Experience with an Intravascular Oxygen Electrode

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Abstract
Umbilical artery catheters [282] with O2 electrodes on their tips were passed into the aortas of 268 newborn [human] infants with severe respiratory illnesses. Of the electrodes, 254 [90%] recorded PaO2 [arterial O2 pressure] satisfactorily for a mean of 66 h; 212 (75%) electrodes were still functioning well when removed, because they were no longer clinically needed, after a mean of 87 h. The 27 electrodes that failed to record PaO2 on insertion, 42 that failed later and 25 that temporarily malfunctioned, were examined after removal from the infants. A structural cause accounted for the failure or malfunction of 43 electrodes. Problems with the remaining 51 electrodes were apparently due to clotting over the tip of the electrode. Main complication of catheterization was temporary impairment of the circulation to the legs in 69 (26%) infants. Autopsies were done on 69 (85%) of the 81 infants who died; 22 (32%) infants had thrombi in an iliac artery, which spread in 10 (15%) to the aorta. The intravascular electrode usually functioned satisfactorily. The incidence of complications was no higher than that with ordinary umbilical artery catheters. Improvements in the performance of the catheter-tip electrode would be expected if structural causes for failure were eliminated and if means to reduce the incidence of clot formation around the catheter and electrode could be found. Apparently, intravascular electrodes cannot be replaced by skin electrodes for the initial management of severe respiratory illnesses.