Individualised pulse oximetry limits in neonatal intensive care

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Abstract
AIM To determine whether individualised limits for arterial oxyhaemaglobin saturation by pulse oximetry (SpO2) are more effective for detecting hypoxia and hyperoxia in sick newborn infants than setting fixed limits. METHODS Six hundred and ninety two simultaneous measurements of SpO2 and partial pressure of oxygen in arterial blood (PaO2) were made in 95 infants. The sensitivity and specificity for predicting hypoxia and hyperoxia using various fixed SpO2 limits and also individualised SpO2 limits, calculated using a standard equation, were determined and compared. RESULTS None of the fixed limits for SpO2 was both sensitive and specific for predicting hypoxia and/or hyperoxia. There was no difference between these and individualised limits. CONCLUSION Individualised SpO2 limits are no more effective than fixed SpO2 limits for predicting hypoxia and/or hyperoxia in sick newborn infants. SpO2 monitoring is not an ideal method for assessing PaO2.