Desaturation events in neonates during mechanical ventilation

This study examines the accuracy of oxygen saturation measured by Nellcor N200 pulse oximetry (SpO₂) compared with arterial oxygen saturation (SaO₂) measured through a three-wavelength fiberoptic umbilical catheter in 10 neonates who needed mechanical ventilation. Real-time SaO₂ was validated with a reference method every 4 hours. Oxygen saturation readings (SaO₂ and SpO₂), along with pulse rate and pulsation, were recorded continuously every second through a computer. Concurrent care events and neonatal responses were recorded. Data were completed on 10 neonates who had an umbilical arterial catheter. Desaturation events (<90%) as measured by both SaO₂ and SpO₂ were described and compared. A total of 959 desaturation events occurred during an average of 51 hours of monitoring per subject. Of these events, 63% were associated with frozen SpO₂ readings, and 18% of frozen readings occurred when SaO₂ was <90%. Bias for SpO₂ compared with SaO₂ was +5.03%, with 5.6% of the readings outside the range of two standard deviations. However, 67% of the readings exceeded the 4% difference criterion between measurements. Future studies need to examine the desaturation events in relation to oxygenation status as measured by different methods.