Table 2.
Continuous pulse oximetry monitoring analytics and outcome studies
| Investigators | Study N Site(s) |
Inclusion criteria | Results/conclusions |
|---|---|---|---|
| Di Fiore et al.57 |
1316 Multicenter |
24 0/7−27 6/7 weeks | SGA infants in lower target SpO2 (85−89%) range achieved lowest oxygen saturation and higher incidence of intermittent hypoxemia in comparison with higher target SpO2 (91−95%) during first 3 days of life. Lowest quartile for saturation (≤92%) in the first 3 days of life is associated with increased 90-day mortality in AGA and SGA infants. |
| Poet et al.56 |
1019 Multicenter |
23 0/7−27 6/7 weeks | Prolonged hypoxemic episodes in first 2−3 months of life increased risk of death or cognitive/motor impairment at 18 months of age. Bradycardia did not alter the prognostic value of hypoxemia. |
| Sullivan et al.63 |
778 Two centers |
<1500 g | Pulse oximetry predictive score (POPS) performed better for prediction of death, IVH and BPD compared to HRC alone. |
| Raffay et al.64 |
137 Single center |
<28 weeks | More frequent, longer and elevated intermittent Hypoxemia (IH) nadirs with increased oxygen and pressure exposure in first 28 days of life increases the risk of BPD. Early IH patterns may contribute to the development of BPD and may help identify infants at risk. |
| Di Fiore et al.66 |
63 Single center |
24 0/7−27 6/7 weeks | Increased variability, longer duration, and lower nadir of hypoxemia is associated with increased risk of severe ROP. Identification of spectral component of SpO2 waveform may aid in identification of infants at risk for severe ROP. |
| Fairchild et al.46 |
1065 Two centers |
<1500 g | HR-SpO2 cross correlation model performed better than HR or SpO2 for preclinical detection of NEC and sepsis. |
| Warburton et al.4 |
94 Single center |
<36 weeks gestation | % of time with SpO2 <90% is associated with risk of respiratory support escalation and decreased weight gain. |
| Das et al.8 |
56 Single center |
<1000 g | Increased SpO2 fluctuation during first 4 weeks of life was higher in infants with severe ROP. No association was found if the time spent was in the target range of SpO2. |
| Mascoll-Robertson et al.67 |
31 Single center |
24 0/7−32 6/7 weeks | Pulse oximetry histogram may be helpful in determining readiness of weaning from CPAP/HFNC to LFNC/oxyhood/RA transition. |
| Vesoulis et al.65 |
645 Multicenter |
<32 weeks or <1500 g | Greater hypoxemia burden in first week of life was significantly associated with grade III/IV IVH. |
| Bizzarro et al.69 |
700 Single center |
<1500 g | Significant reduction in severe ROP and ROP requiring surgery after staff education and implementation of signal extraction technology to quantify success with achieved target oxygen saturations. |
SGA small for gestational age, AGA appropriate for gestational age, SpO2 oxygen saturation, POPS pulse oximetry predictive scores, IVH intraventricular hemorrhage, BPD bronchopulmonary dysplasia, HRC heart rate characteristics, ROP retinopathy of prematurity, NEC necrotizing enterocolitis, CPAP continuous positive airway pressure, HFNC high flow nasal cannula, LFNC low flow nasal cannula, RA room air, HUS head ultrasound