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Low signal quality pulse oximetry measurements in newborn infants are reliable for oxygen saturation but underestimate heart rate
Author(s) -
Narayen Ilona C.,
Smit Marrit,
Zwet Erik W.,
Dawson Jennifer A.,
Blom Nico A.,
te Pas Arjan B.
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12932
Subject(s) - medicine , pulse oximetry , heart rate , oxygen saturation , pulse (music) , cardiology , anesthesia , pediatrics , oxygen , blood pressure , chemistry , organic chemistry , detector , electrical engineering , engineering
Aim We assessed the influence of system messages (SyMs) on oxygen saturation (SpO 2 ) and heart rate measurements after birth to see whether clinical decision‐making changed if clinicians included SyM data. Methods The heart rate and SpO 2 of term infants were recorded using Masimo pulse oximeters. Differences in means and standard deviations ( SD ) were calculated. Permutation corrected the nonrandom distribution and intersubject variation. SpO 2 and heart rate centile charts were computed with, and without, SyMs. Results Pulse oximetry measurements from 117 neonates provided 28 477 data points. SyMs occurred in 46% of measurements. Low signal quality accounted for 99.9% of SyMs. The mean SpO 2 was lower with SyMs (p < 0.001), while the SpO 2 SD was similar to data without SyMs. The SpO 2 centile charts were approximately 2% lower with SyMs included, but they were not more dispersed. Mean heart rate was lower (p < 0.001) and more dispersed (p < 0.001) when a SyM occurred. The heart rate centile charts were lower, with increased variability, when SyMs were included. Conclusion A SyM occurred frequently during pulse oximetry in term infants after birth. SpO 2 measurements with low signal quality proved reliable for monitoring an infant's clinical condition. However, heart rate could be underestimated by low signal quality measurements.