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Continuous Oxygen Monitoring of the Conjunctiva in Neonates

Journal of Perinatology volume 22, pages 46–49 (2002)Cite this article

Abstract

OBJECTIVE: To report the first use of a noninvasive conjunctival oxygen monitor in neonates. We wished to investigate if measuring the partial pressure of oxygen directly from the conjunctiva could track hyperoxia and hypoxia as well as, or better than, pulse oximetry. This has the potential to reflect brain oxygenation while yielding important systemic information.

STUDY DESIGN: Criteria standard.

SETTING: Tertiary care hospital neonatal intensive care unit.

PATIENTS: Ten newborns monitored with pulse oximetry.

INTERVENTION: The conjunctival oxygen monitor was studied for effectiveness and safety and compared to pulse oximetry.

RESULTS: The device remained on the eyes up to 120 minutes. The correlation coefficient between conjunctival oxygen tension and pulse oximetry was significant for all readings (p<0.001) and for pulse oximetry measurements below 100% (p=0.024). One infant developed eyelid edema, which subsided when the device was removed and one sustained a small corneal abrasion that healed overnight.

CONCLUSION: This initial pilot report suggests that the conjunctival oxygen monitor is effective and relatively safe in neonates. The device holds promise to indicate a tissue oxygen reading, which may provide neonatologists with more information about systemic oxygenation.

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References

  1. Lucey JF, Dangman B . A re-examination of the role of oxygen in retrolental fibroplasia Pediatrics 1984 73: 82–96

    CAS  PubMed  Google Scholar 

  2. The STOP-ROP Multicenter Study Group. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP), a randomized, controlled trial: I. Primary outcomes Pediatrics 2000 105: 295–310

  3. Gerhard JP, Willard D, Messer J . Evolution of the visual prognosis of prematures in the last 20 years Graefe's Arch Clin Exp Ophthalmol 1986 224: 62–3

    Article  CAS  Google Scholar 

  4. Jennis MS, Peabody JL . Pulse oximetry: an alternative method for the assessment of oxygenation in newborn infants Pediatrics 1987 79: 524–8

    CAS  PubMed  Google Scholar 

  5. Fanconi S, Doherty P, Edmonds JF, Barker GA, Bohn DJ . Pulse oximetry in pediatric intensive care: comparison with measured saturations and transcutaneous oxygen tension J Pediatr 1985 107: 362–6

    Article  CAS  Google Scholar 

  6. REF

  7. Isenberg SJ, Shoemaker WC . The transconjunctival oxygen monitor Am J Ophthalmol 1983 95: 803–6

    Article  CAS  Google Scholar 

  8. Isenberg SJ, Green BF . Effect of phenylephrine on conjunctival oxygen tension Arch Ophthalmol 1984 102: 1185–6

    Article  CAS  Google Scholar 

  9. Isenberg SJ, McRee WE, Jedrzynski MS . Progressive conjunctival hypoxia in diabetes mellitus Invest Ophthalmol Vis Sci 1986 27: 1512–4

    CAS  Google Scholar 

  10. Isenberg SJ, McRee WE, Jedrzynski MS, Gange SN, Gange SL . Effects of sickle cell anemia on conjunctival oxygen tension and temperature Arch Intern Med 1987 147: 67–9

    Article  CAS  Google Scholar 

  11. Isenberg SJ, Green BF . Conjunctival temperature and oxygen tension in smoking and essential hypertension In: Blodi F, Brancato R, Cristini G, d'Ermo F, Esemle I, Musini A, et al., editors. Acta XXV Concilium Ophthalmologicum. Proceedings of the XXVth International Congress of Ophthalmology Rome: Kugler and Ghedini 1988 2634–8

  12. Abraham E, Fink S . Conjunctival oxygen tension monitoring in emergency department patients Ann Emerg Med 1988 16: 549–54

    Google Scholar 

  13. Rutherford W, Panacek E, Griffith J . Prediction of cerebral blood flow by use of the conjunctival oxygen/arterial oxygen tension index Crit Care Med 1989 17: 1328–32

    Article  CAS  Google Scholar 

  14. Isenberg SJ, McCarty JW, Rich R . Growth of conjunctival fornices and orbital margin in term and premature infants Ophthalmology 1987 94: 1276–8

    Article  CAS  Google Scholar 

  15. Isenberg SJ, Green BF . Changes in conjunctival oxygen tension and temperature with advancing age Crit Care Med 1985 13: 683–5

    Article  CAS  Google Scholar 

  16. Sorbini CA, Grassi V, Solinas E, Muiesan G . Arterial oxygen tension in relation to age in healthy subjects Respiration 1968 25: 3–13

    Article  CAS  Google Scholar 

  17. Kinsey VE, Arnold HJ, Kalina E et al. p aO2 levels and retrolental fibroplasia: a report of the cooperative study Pediatrics 1977 60: 655–68

    CAS  PubMed  Google Scholar 

  18. Penn JS, Henry MM, Tolman BL . Exposure to alternating hypoxia and hyperoxia causes severe proliferative retinopathy in the newborn rat Pediatr Res 1994 36: 724–31

    Article  CAS  Google Scholar 

  19. Chan-Ling T, Gock B, Stone J . The effect of oxygen on vasoformative cell division Invest Ophthalmol Vis Sci 1995 36: 1201–14

    CAS  PubMed  Google Scholar 

  20. MacMahon P, Fleming PJ, Speidel BD, Dunn PM . Low inspired oxygen concentrations in very-low-birthweight infants needing ventilatory support: an approach to the prevention of retrolental fibroplasia Brit J Obstet Gynecol 1986 93: 361–3

    CAS  Google Scholar 

  21. Pierce EA, Foley ED, Smith LEH . Regulation of vascular endothelial growth factor by oxygen in a model of retinopathy of prematurity Arch Ophthalmol 1996 114: 1219–28

    Article  CAS  Google Scholar 

  22. Stone J, Chan-Ling T, Pe'er J, Itin A, Gnessin H, Keshet E . Roles of vascular endothelial growth factor and astrocyte degeneration in the genesis of retinopathy of prematurity Invest Ophthalmol Vis Sci 1996 37: 290–9

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Departments of Ophthalmology and Pediatrics, Jules Stein Eye Institute, Harbor/UCLA Medical Center, UCLA School of Medicine, Los Angeles and Torrance, Torrance, CA, USA

    Sherwin J Isenberg MD & Robert Rich RN

  2. Wolfson Medical Center, Holon, Israel

    Doron Neumann MD

  3. Guidant Corporation, Santa Clara, CA, USA

    Stanley Fink PhD

Authors
  1. Sherwin J Isenberg MD
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  2. Doron Neumann MD
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  3. Stanley Fink PhD
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  4. Robert Rich RN
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Additional information

This study was supported, in part, by the Margaret Bundy Scott Trust, Blind Children's Center (Los Angeles), Crail-Johnson Foundation, and National Institutes of Health grant RR00425.

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Isenberg, S., Neumann, D., Fink, S. et al. Continuous Oxygen Monitoring of the Conjunctiva in Neonates. J Perinatol 22, 46–49 (2002). https://doi.org/10.1038/sj.jp.7210602

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