Randomised crossover study on pulse oximeter readings from different sensors in very preterm infants

Objective In extremely preterm infants, different target ranges for pulse oximeter saturation (SpO2) may affect mortality and morbidity. Thus, the impact of technical changes potentially affecting measurements should be assessed. We studied SpO2 readings from different sensors for systematic deviati...

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Main Authors: Maiwald, Christian Achim (Author) , Schwarz, Christoph (Author) , Böckmann, Katrin (Author) , Springer, Laila (Author) , Poets, Christian F. (Author) , Franz, Axel (Author)
Format: Article (Journal)
Language:English
Published: December 21,2023
In: Archives of disease in childhood. Fetal & neonatal
Year: 2024, Volume: 109, Issue: 4, Pages: 391-396
ISSN:1468-2052
DOI:10.1136/archdischild-2023-325961
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1136/archdischild-2023-325961
Verlag, kostenfrei, Volltext: https://fn.bmj.com/content/early/2023/12/21/archdischild-2023-325961
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Author Notes:Christian Achim Maiwald, Christoph E. Schwarz, Katrin Böckmann, Laila Springer, Christian F. Poets, Axel Franz
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Summary:Objective In extremely preterm infants, different target ranges for pulse oximeter saturation (SpO2) may affect mortality and morbidity. Thus, the impact of technical changes potentially affecting measurements should be assessed. We studied SpO2 readings from different sensors for systematic deviations. - Design Single-centre, randomised, triple crossover study. - Setting Tertiary neonatal intensive care unit. - Patients 24 infants, born at <32 weeks’ gestation, with current weight <1500 g and without right-to-left shunt via a patent ductus arteriosus. - Interventions Simultaneous readings from three SpO2 sensors (Red Diamond (RD), Photoplethysmography (PPG), Low Noise Cabled Sensors (LNCS)) were logged at 0.5 Hz over 6 hour/infant and compared with LNCS as control using analysis of variance. Sensor position was randomly allocated and rotated every 2 hours. Seven different batches each were used. - Outcomes Primary outcome was the difference in SpO2 readings. Secondary outcomes were differences between sensors in the proportion of time within the SpO2-target range (90-95 (100)%). - Results Mean gestational age at birth (±SD) was 274/7 (±23/7) weeks, postnatal age 20 (±20) days. 134 hours of recording were analysed. Mean SpO2 (±SD) was 94.0% (±3.8; LNCS) versus 92.2% (±4.0; RD; p<0.0001) and 94.5% (±3.9; PPG; p<0.0001), respectively. Mean SpO2 difference (95% CI) was −1.8% (−1.9 to −1.8; RD) and 0.5% (0.4 to 0.5; PPG). Proportion of time in target was significantly lower with RD sensors (84.8% vs 91.7%; p=0.0001) and similar with PPG sensors (91.1% vs 91.7%; p=0.63). - Conclusion There were systematic differences in SpO2 readings between RD sensors versus LNCS. These findings may impact mortality and morbidity of preterm infants, particularly when aiming for higher SpO2-target ranges (eg, 90-95%). - Trial registration number DRKS00027285.
Item Description:Gesehen am 12.03.2024
Physical Description:Online Resource
ISSN:1468-2052
DOI:10.1136/archdischild-2023-325961