Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Objective: To determine if a change in the pulse oximeter goal range and high alarm limit for oxygen saturation (SpO(2)) alters the distribution of SpO(2) for premature infants in oxygen. Study design: This was a prospective, observational analysis. For group 1 ( February 2002 to April 2002, n = 23), pulse oximeter alarms were set at 80% ( low) and 96% ( high), and the goal range was 90 - 95%. For group 2 ( May 2002 to August 2003, n 49), the high alarm was lowered to 94%, and the goal range was 88 to 94%. The SpO(2) values for 24 h were downloaded from Nellcor pulse oximeters during the two periods and the percent time within, above and below the goal range was derived and compared. Results: Groups were similar except for use of post-natal steroids ( group 2> 1). The percent time within ( 57.7 +/- 9.8 vs 59.4 +/- 12.4%), above (15.4 +/- 10.6 vs 14 +/- 9.4%) and below (26.9 +/- 9.7 vs 26.6 +/- 10.2%) the goal range was similar for groups 1 and 2, respectively. However, the percent time with SpO(2) < 80% increased significantly for group 2 (4.0 +/- 2.7 vs 1.9 +/- 1.4%). Conclusions: Changes in pulse oximeter policy and alarms in labile, sick premature infants need evaluation for their effects on the distribution of SpO(2) values before routine use.