Transcutaneous monitoring of oxygenation: what is normal?

We examined 55 infants on 119 occasions, from birth to 6 months, to obtain normal data and to establish guidelines for the management of oxygen-dependent infants with chronic lung disease. Transcutaneous oxygen tension (tcPo2) and saturation (tcSao2) were monitored during four states: awake, feeding, quiet sleep, and active sleep. Lowest values (mean +/- SD) for tcSao2 were recorded in all states during the first week of life: awake 96.2% +/- 2.6%, feeding 91.2% +/- 3.7%, quiet sleep 93.2% +/- 2.9%, and active sleep 92.1% +/- 2.9%. After the first week the results were affected by state rather than age, with differences observed between awake and feeding (P less than 0.0001), awake and asleep (P less than 0.00001), and quiet sleep and active sleep (P less than 0.001). The findings for tcPo2 were less consistent and probably affected by the characteristics of skin. In the first week, values were as follows: awake 83.5 +/- 10.1 mm Hg, feeding 73.4 +/- 10.1 mm Hg, quiet sleep 78.5 +/- 10.9 mm Hg, and active sleep 73.4 +/- 11.4 mm Hg. Subsequently, only the state effect remained, and significant differences existed between awake and feeding (P less than 0.0001) and awake and asleep (P less than 0.00001). We conclude that transcutaneous blood gas measurements are affected by state of the infant.

[1]  R. Deckardt,et al.  Noninvasive arterial hemoglobin oxygen saturation versus transcutaneous oxygen tension monitoring in the preterm infant. , 1984 .

[2]  J. Newburger,et al.  Cognitive function and age at repair of transposition of the great arteries in children. , 1984, The New England journal of medicine.

[3]  Axel Fenner,et al.  Periodic Breathing in Premature and Neonatal Babies: Incidence, Breathing Pattern, Respiratory Gas Tensions, Response to Changes in the Composition of Ambient Air , 1973, Pediatric Research.

[4]  M. Peterson,et al.  Breathing pattern and ventilation during oral feeding in term newborn infants. , 1985, The Journal of pediatrics.

[5]  S. Gidding,et al.  Transcutaneous oxygen monitoring. Its use in the treatment of outpatients with congenital heart disease. , 1985, A M A Journal of Diseases of Children.

[6]  M. Sterman,et al.  Polygraphic studies of normal infants during the first six months of life: III. Incidence of apnea and periodic breathing. , 1977, Pediatrics.

[7]  A. C. Bryan,et al.  Respiratory induction plethysmography (Respitrace): an evaluation of its use in the infant. , 1981, The American review of respiratory disease.

[8]  A C Bryan,et al.  Changes in ventilation and chest wall mechanics during sleep in normal adolescents. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[9]  M. H. Bryan,et al.  Low flow oxygen therapy in infants. , 1983, Archives of disease in childhood.

[10]  D. Shannon,et al.  Periodic breathing in infants with near-miss sudden infant death syndrome. , 1979, Pediatrics.

[11]  A C Bryan,et al.  Diaphragmatic muscle fatigue in the newborn. , 1979, Journal of applied physiology: respiratory, environmental and exercise physiology.

[12]  M. Hanson,et al.  The response to hypoxia of arterial chemoreceptors in fetal sheep and new‐born lambs. , 1984, The Journal of physiology.

[13]  A. Wilkinson,et al.  Oxygen and carbon dioxide tensions, breathing and heart rate in normal infants during the first six months of life. , 1981, Journal of developmental physiology.

[14]  A. Fanaroff,et al.  Decreased ventilation in preterm infants during oral feeding. , 1983, The Journal of pediatrics.

[15]  D. Bohn,et al.  Pulse oximetry in pediatric intensive care: comparison with measured saturations and transcutaneous oxygen tension. , 1985, The Journal of pediatrics.

[16]  Mark Yelderman,et al.  Evaluation of pulse oximetry. , 1983, Anesthesiology.

[17]  J R Alexander,et al.  Sequential 22-hour profiles of breathing patterns and heart rate in 110 full-term infants during their first 6 months of life. , 1984, Pediatrics.

[18]  M. Sterman,et al.  Polygraphic Studies of Normal Infants during the First Six Months of Life. I. Heart Rate and Variability as a Function of State , 1976, Pediatric Research.

[19]  J. Peabody,et al.  Transcutaneous Po2 monitoring in the home management of bronchopulmonary dysplasia. , 1978, Pediatrics.

[20]  D Rubin,et al.  Arterial oxygen tension during active and quiet sleep in the normal neonate. , 1979, The Journal of pediatrics.

[21]  N. Finer,et al.  Ventilation and sleep states in newborn infants. , 1976, The Journal of pediatrics.

[22]  H. Bucher,et al.  Transcutaneous PO2 monitoring in routine management of infants and children with cardiorespiratory problems. , 1976, Pediatrics.

[23]  H. Prechtl,et al.  The behavioural states of the newborn infant (a review). , 1974, Brain research.