Pulse Oximetry in the NICU: Conventional Vs Masimo SET

Abstract 1790 Poster Session II, Sunday, 5/2 (poster 44)

Pulse oximetry is widely used in the NICU, but numerous false alarms can cause clinicians to distrust displayed oxygen saturation (%SpO₂) and pulse rate (PR) values. Masimo Corp. (Irvine, CA) has developed a unique sensor design and signal processing algorithms (Masimo SET) that detect and discard sources of interference in %SpO₂ and PR. A study population was selected at random among NICU infants that were unsedated and on supplemental oxygen and/or mechanical ventilation. Masimo LNOP Neo and Nellcor N-25 sensors were placed on opposite feet and attached to the Masimo SET and Nellcor N-200 pulse oximeters, respectively. Each infant was monitored for a total of 6 hours. The sensors were switched in the middle (at 3 hours) of each case. Data (ECG heart rate from Datascope Passport, %SpO₂ and PR from the two pulse oximeters) were sampled from the serial output of each device once every second (1 Hz) by a PC data acquisition system. The raw pulse oximeter waveform was analyzed whenever either the Nellcor or Masimo pulse oximeters had detected hypoxemia. This technique (Comp. Biol. Med. 26:143-159, 1996) allows a manual SpO₂ reference which has been shown to be reliable in determining "False" %SpO₂ readings. A total of 156 hours of monitoring time was accumulated and examined for false %SpO₂ alarms, and true and false bradycardic events. False %SpO₂ and PR alarms occurring at the same time were counted as one alarm. Results: Masimo SET demonstrated a 92% reduction in (Table) false hypoxia and bradycardia alarm duration. Also, Masimo SET identified 12 of 14 bradycardias (86%) versus 2 o/f 14 (14%) for the Nellcor. Conclusions: Routine use of Masimo SET pulse oximetry in the NICU should result in dramatically fewer false %SpO₂ alarms and zero-outs, while capturing more true events than use of conventional pulse oximetry. Better monitoring should lead to more timely clinical interventions, indicating also that O₂ could be more effectively titrated leading to possible reductions in hypoxic (e.g., pulmonary hypertension) and hyperoxic (e.g., retinopathy) pathology.

Table 1 No caption available

Study was funded by Masimo Corp however authors hold no equity in said company.