Accuracy of two wavelength pulse oximetry in neonates and infants

Abstract

In 60 neonates (gestational age, 26.5–40 weeks; postnatal age, 1–14 days) and in 11 infants (gestational age, 26–33 weeks; postnatal age, 4.5–38 weeks), the accuracy of two wavelength pulse oximetry was examined. A total of 112 comparisons between transcutaneous pulse oximetry saturation (StcO₂, NELLCOR™ N‐100) and arterial oxygen saturation (SaO₂, OSM2 RADIOMETER™) were obtained. SaO₂ ranged from 80 to 100%. Criteria for comparison between StcO₂ and SaO₂ were standardized: patients in behavioral state 1, StcO₂ stable for 2 min, and arterial samples drawn from an indwelling arterial line. StcO₂ was significantly related to SaO₂ (P < 0.01), but the difference, StcO₂ ‐ SaO₂, significantly increased when SaO₂ decreased [StcO₂ ‐ SaO₂ (%) = ‐0.39 SaO₂(%) + 37.95; r = ‐0.64, P 2 ‐ SaO₂ and either bilirubinemia (range, 5–222 m̈mol/L) or fetal hemoglobin (HbF) (range, 12–95%). We conclude that StcO₂ overestimates SaO₂ when SaO₂ decreases, and this overestimation is not due to high levels of bilirubin or HbF.