Abstract
Background: Pulse oximetry (PO) gives continuous and objective measures of heart rate (HR) and oxygen saturation. It is used routinely to monitor infants in intensive care. HR is critical in guiding interventions during neonatal resuscitation and is monitored clinically. This is subjective, intermittent, may be difficult and inaccurate. Though not widely used at resuscitation, PO may be useful in objectively detecting HR and titrating FiO2. There are different methods of applying PO probes. We wished to determine the time taken to apply a probe, the time to display accurate HR data and the proportion of correct first displayed HR for each of three methods.
Methods: Randomised crossover study of infants monitored with PO and ECG using a Masimo Radicalâ„¢ (Masimo, USA) pulse oximeter. All were supine. The probe was applied to the right wrist or hand. It was applied to each infant on three occasions using the following methods: 1. probe connected to PO, then applied to neonate 2. probe connected to PO, applied to investigator's finger, then to infant 3. probe applied to infant, then connected to PO. The order in which the methods were used was allocated randomly. The time taken to apply the probe, to display data and to display accurate HR (ie. values that matched ECG values) were recorded with a stopwatch. The number of accurate first HR for each method was noted. Data were analysed using SPSS.
Results: We studied 40 babies, whose weights, gestational and postnatal ages varied.
There were no significant differences in the time taken to apply the probe using each method. The mean difference in the time to display correct HR between methods 1 and 3 was 10 seconds (p= 0.004). The total time taken to display accurate HR data was quickest for method 3 followed by method 2 then 1. The mean difference in the total time between methods 3 and 1 was 7 seconds (p< 0.05) but the differences between paired methods 3/2 and 1/2 did not reach statistical significance. The proportion of correct first displayed HR was 80%, 28% and 93% for methods 1, 2 and 3 respectively. Thus, although method 1 took slightly longer to apply the probe, it was the quickest to display accurate HR data.
Conclusion: Applying the probe to the right hand or wrist before connection to the Masimo Radical pulse oximeter results in quicker acquisition of HR data which is more accurate in infants in intensive and special care settings. This method of probe application may be preferred during neonatal resuscitation.
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O'Donnell, C., Kamlin, C., Davis, P. et al. 126 Obtaining Pulse Oximetry Data in Infants - A Randomised Crossover Study of Probe Application Techniques. Pediatr Res 56, 485 (2004). https://doi.org/10.1203/00006450-200409000-00149
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DOI: https://doi.org/10.1203/00006450-200409000-00149