Sally Jasmine Maia Ahmed1, Wade Rich, Neil Norman Finer. 1. Section of Neonatology and Developmental Biology, Departmentof Pediatrics, University of Arizona, Tucson, Arizona 85724, USA. sjasmineahmed@gmail.com
Abstract
BACKGROUND: The effect of a pulse oximeter's averaging time on time spent by premature infants in established saturation ranges, as well as on desaturation events, has not previously been reported. OBJECTIVE: Our goal for this pilot study was to evaluate the effect of 2 distinct averaging times on the amount of time spent outside target oxygen saturation (SPo(2)) as well as the types and durations of desaturation events. METHODS: Neonates <32 weeks' gestation requiring respiratory support were included. Each infant was studied with 2 simultaneous pulse oximeters: 1 with a short averaging time (2 seconds) and 1 with a longer averaging time (16 seconds). Time spent within different saturation ranges and the number, duration, and severity of desaturation events for each averaging time were compared by using Student's 2-tailed t test, and a P value of <.05 was considered significant. RESULTS: The number of desaturations was greater with the 2-second averaging time; however, it did not reach significance when only desaturations of clinically significant duration were included (22.3 vs 19.4 significant events were detected by 2- and 16-second averaging time; P = .1). There was a trend for the longer averaging time to underestimate brief desaturation lasting <30 seconds (16 vs 41). Longer averaging time also tended to overestimate events of long duration that lasted >300 seconds (40 vs 20 long events). Longer averaging time tended to underestimate desaturation events of greater severity when SPo(2) was <70% (P = .01). Averaging time did not affect the time spent within various target SPo(2) ranges (P > .05). CONCLUSIONS: These preliminary results suggest that use of longer averaging time reduces the detection of brief periodic desaturation events and of greater severity. It may also interpret a cluster of shorter events as a single, prolonged episode and, thus, potentially overestimate the frequency of long events. The significance of these findings lies in the potential impact on neurodevelopmental outcomes and growth, which will need additional study.
BACKGROUND: The effect of a pulse oximeter's averaging time on time spent by premature infants in established saturation ranges, as well as on desaturation events, has not previously been reported. OBJECTIVE: Our goal for this pilot study was to evaluate the effect of 2 distinct averaging times on the amount of time spent outside target oxygen saturation (SPo(2)) as well as the types and durations of desaturation events. METHODS: Neonates <32 weeks' gestation requiring respiratory support were included. Each infant was studied with 2 simultaneous pulse oximeters: 1 with a short averaging time (2 seconds) and 1 with a longer averaging time (16 seconds). Time spent within different saturation ranges and the number, duration, and severity of desaturation events for each averaging time were compared by using Student's 2-tailed t test, and a P value of <.05 was considered significant. RESULTS: The number of desaturations was greater with the 2-second averaging time; however, it did not reach significance when only desaturations of clinically significant duration were included (22.3 vs 19.4 significant events were detected by 2- and 16-second averaging time; P = .1). There was a trend for the longer averaging time to underestimate brief desaturation lasting <30 seconds (16 vs 41). Longer averaging time also tended to overestimate events of long duration that lasted >300 seconds (40 vs 20 long events). Longer averaging time tended to underestimate desaturation events of greater severity when SPo(2) was <70% (P = .01). Averaging time did not affect the time spent within various target SPo(2) ranges (P > .05). CONCLUSIONS: These preliminary results suggest that use of longer averaging time reduces the detection of brief periodic desaturation events and of greater severity. It may also interpret a cluster of shorter events as a single, prolonged episode and, thus, potentially overestimate the frequency of long events. The significance of these findings lies in the potential impact on neurodevelopmental outcomes and growth, which will need additional study.
Authors: Erik A Jensen; Huayan Zhang; Rui Feng; Kevin Dysart; Kathleen Nilan; David A Munson; Haresh Kirpalani Journal: Arch Dis Child Fetal Neonatal Ed Date: 2019-11-04 Impact factor: 5.747
Authors: Augusto Sola; Sergio G Golombek; María Teresa Montes Bueno; Lourdes Lemus-Varela; Claudia Zuluaga; Fernando Domínguez; Hernando Baquero; Alejandro E Young Sarmiento; Diego Natta; Jose M Rodriguez Perez; Richard Deulofeut; Ana Quiroga; Gabriel Lara Flores; Mónica Morgues; Alfredo García-Alix Pérez; Bart Van Overmeire; Frank van Bel Journal: Acta Paediatr Date: 2014-07-28 Impact factor: 2.299