Intermittent pulse oximeter as a measurement of newborn oxygen: a cross-sectional study

Prima Hari Nastiti; Kartika Darma Handayani; Taufiq Hidayat; Dina Angelika; I Ketut Alit Utamayasa; Risa Etika; Mahrus A. Rachman; Martono Tri Utomo

doi:10.15562/bmj.v12i3.4688

Intermittent pulse oximeter as a measurement of newborn oxygen: a cross-sectional study

Prima Hari Nastiti ,

Kartika Darma Handayani ,

Taufiq Hidayat ,

Dina Angelika ,

I Ketut Alit Utamayasa ,

Risa Etika ,

Mahrus A. Rachman ,

Martono Tri Utomo ,

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DOI: https://doi.org/10.15562/bmj.v12i3.4688 |
Published: 2023-08-22

Abstract

Introduction: Intermittent monitoring using fingertip pulse oximeters is increasingly being used in guiding oxygen therapy and screening congenital heart defects in newborns. However, there are no evidence-based guidelines for using fingertip pulse oximeters for intermittent monitoring of newborns in low-resource settings. This research assesses the validity of the fingertip pulse oximeter to measure oxygen saturation in newborns against the continuous monitoring pulse oximeter as a standard method.

Method: A prospective study was conducted in the NICU and Neonatal Intermediate Unit of Dr. Soetomo Academic Hospital Surabaya. Newborns aged below 28 days using a respiratory device were included. Oxygen saturation measurements using a continuous monitoring pulse oximeter and intermittent pulse oximeter were done on the right hand and both feet. Paired t-test and Bland-Altman plot was performed to assess the validity.

Results: Eighty-five neonates were included. There is an agreement between Intermittent and continuous pulse oximeters in the normoxic group with a limit of agreement -1.29 (CI 95% -1.62 to -0.95) to 1.29 (CI 95% 0.95 to 1.62) and hypoxic group with a limit of agreement -3.36 (CI 95% -4.29 to -2.44) to 3.00 (CI 95% 2.08 to 3.92). Intermittent pulse oximeter measurement requires a longer time for maximum results compared to continuous pulse oximeter (p=0.001).

Conclusions: The intermittent pulse oximeter is available to be used alternately with a continuous pulse oximeter. However, it has limitations in hypoxemia settings, hence the application in real-time clinical practice needs further study.

References

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O’Donnell CPF, Kamlin COF, Davis PG, Morley CJ. Feasibility of and delay in obtaining pulse oximetry during neonatal resuscitation. J Pediatr. 2005;147(5):698–9. https://doi.org/10.1016/j.jpeds.2005.07.025.
Elbana HM, Elhady RMA, Mohammed HR. Self-Care Management Program Utilization among Antenatal Mothers with Pregnancy-Induced Hypertension. J Med Chem Sci. 2022;5(1):103-115. doi: 10.26655/JMCHEMSCI.2022.1.12.
Herbert LJ, Wilson IH. Pulse oximetry in low-resource settings. Breathe. 2012;9(2):90-97. doi: https://doi.org/10.1183/20734735.038612.
Ebrahem AM, Jameel SK, Abbas AH.I nvestigation of Biofilm Formation and Antibiotic Resistant of Bacteria Isolated from Septic Neonates. J Med Chem Sci. 2023;6(4):816-826. doi: https://dx.doi.org/10.26655/JMCHEMSCI.2023.4.13.
Setianingsih H, Ilmawan MF, Nawangsasi P. HBO's Impact on the Prevention and Therapy of Atherosclerotic Heart Disease through Matrix Metalloproteinase-12 (MMP-12) Expression. J Med Chem Sci. 2023;6(12):2867-2876. doi: https://doi.org/10.26655/JMCHEMSCI.2023.12.1.
Dhivya R, Arun PD, Yachendra VSG, Surya R, Lakshmi R. Modified Lung Ultrasound Score to Determine the Degree of Perioperative Atelectasis in Adults Undergoing Elective Laparoscopic Surgery Under General Anaesthesia- A Prospective Observational Study. J Med Chem Sci. 2023;6(9):2104-2110. doi: https://doi.org/10.26655/JMCHEMSCI.2023.9.17.
Rochayati I, Putra ST, Supriyatno B. Akurasi Pulse Oksimetri Fingertip Dibandingkan Pulse Oksimetri Generasi Baru dalam Deteksi Dini Penyakit Jantung Bawaan Kritis pada Bayi baru Lahir: Penelitian Pendahuluan. Sari Pediatr. 2016;17(2):113. doi: http://dx.doi.org/10.14238/sp17.2.2015.113-8.
Levesque BM, Pollack P, Griffin BE, Nielsen HC. Pulse oximetry: What’s normal in the newborn nursery?. Pediatr Pulmonol. 2000;30(5):406–12. doi: https://doi.org/10.1002/1099-0496(200011)30:5<406::AID-PPUL7>3.0.CO;2-C.
Akram NN, Abed MY. Indications and Outcome of Albumin Infusion in a Neonatal Population: A Cross Sectional Study. J Med Chem Sci. 2022;5(1):129-136. doi: 10.26655/JMCHEMSCI.2022.1.14.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;8:307–10. doi: https://doi.org/10.1128/AAC.00483-18.
Farhanah N, Supriadi S, Wahjono H, Hadisaputro S, Gasem MH. Predictors of Mortality in Sepsis Patients Resulting from Severe and Critical COVID-19. J Med Chem Sci. 2023;6(9):2018-2027. doi: https://doi.org/10.26655/JMCHEMSCI.2023.9.10.
Schmitt HJ, Schuetz WH, Proeschel PA, Jaklin C. Accuracy of pulse oximetry in children with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth. 1993;7(1):61–5. doi: https://doi.org/10.1016/1053-0770(93)90120-A.
Ewer AK, Middleton LJ, Furmston AT, Bhoyar A, Daniels JP, Thangaratinam S, et al. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): A test accuracy study. Lancet. 2011;378(9793):785–94. doi: http://doi.org/10.1016/S0140-6736(11)60753-8.
Abiri S, Shiri AH, Jahromi MSS, Rayatdoost E, Afkhami H, Ravanshad R, Hosseini SE, Kalani N, Heidari P, Raoufi R. Safety and Efficacy of Popular Iranian Herbal Cold Remedy for COVID-19: A Randomized Clinical Trial in Mild to Moderate COVID-19 Cases. J Med Chem Sci. 2023;6(8):1799-1809. doi: https://doi.org/10.26655/JMCHEMSCI.2023.8.8.
Poets CF, Wilken M, Seidenberg J, Southall DP, von der Hardt H. Reliability of a pulse oximeter in the detection of hyperoxemia. J Pediatr. 1993;122(1):87–90. doi: https://doi.org/10.1016/S0022-3476(05)83494-8.
Schwartz BN, Hom LA, von Kohorn I, Becker J, Cuzzi SS, Grier Clarke SE, et al. Newborn pulse oximetry screening at a community hospital: An 8-year experience. Pediatrics. 2021;148(3). doi: https://doi.org/10.1542/peds.2020-049847.
Secker C, Spiers P. Accuracy of pulse oximetry in patients with low systemic vascular resistance. Anaesthesia. 1997;52(2):127–30. doi: https://doi.org/10.1111/j.1365-2044.1997.32-az0062.x.
Francis C, Kucinski A, Atalay L, Dar S, Shaat F. Pediatric Pulse Oximeter for Low Resource Countries. Honors Theses. 2001 :2538.
Adibi P, Vatankhah M, Razavi BM, Fendereski F, Malekshoar M. Intravenous Pethidine versus Diclofenac Suppository in Shivering after Cesarean Section under Spinal Anesthesia. J Med Chem Sci. 2022;5(7):1142-1149. doi: https://doi.org/10.26655/JMCHEMSCI.2022.7.1.
Susyanto BE, Puspita G, Suryanto S. A 5-year-old child with hemolytic anemia caused by glucose-6-phosphate dehydrogenase deficiency: a case report. Bali Med J. [Internet]. 2021 Dec. 30 [cited 2023 Aug. 4];10(3):1178-80. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/2877.
Sanjaya INH, Pemayun CIM, Purwanti NWD, Sakuntari MDV, Gianni NPN, Putri NLMDMC, Pirgantari NKA, Satriani NLMDL, Mintariani FS, Padmawati NLPY, Putri AAW. Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report. Bali Med J. [Internet]. 2021 Jan. 25 [cited 2023 Aug. 4];10(1):8-10. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/2024.
Shahnaz AA, Manggala Pasca Wardhana, Ernawati, Grace Ariani, Budi Utomo. Placental apoptotic index on COVID-19 and non-COVID-19 cases: a cross sectional study. Bali Med J. [Internet]. 2023 Mar. 3 [cited 2023 Aug. 4];12(1):916-20. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/4200.

[1] Sayganov SA, Mazurov V, Silin AV, Shmatko AD, Gaivoronsky IV. Development of Digital Competence of Portable Telemedicine Complex Operators for Optimizing the Provision of Medical Care. J Med Chem Sci. 2021;4(6):593-602. doi: 10.26655/JMCHEMSCI.2021.6.8.

[2] Danesh H, Motaharian ES, Alimoradzadeh R, Masoudi A, Taebi M. A Review of Laboratory Studies in COVID-19 in Different Patients. J Med Chem Sci. 2021;4(5):434-443. doi: 10.26655/JMCHEMSCI.2021.5.4.

[3] O’Donnell CPF, Kamlin COF, Davis PG, Morley CJ. Feasibility of and delay in obtaining pulse oximetry during neonatal resuscitation. J Pediatr. 2005;147(5):698–9. https://doi.org/10.1016/j.jpeds.2005.07.025.

[4] Elbana HM, Elhady RMA, Mohammed HR. Self-Care Management Program Utilization among Antenatal Mothers with Pregnancy-Induced Hypertension. J Med Chem Sci. 2022;5(1):103-115. doi: 10.26655/JMCHEMSCI.2022.1.12.

[5] Herbert LJ, Wilson IH. Pulse oximetry in low-resource settings. Breathe. 2012;9(2):90-97. doi: https://doi.org/10.1183/20734735.038612.

[6] Ebrahem AM, Jameel SK, Abbas AH.I nvestigation of Biofilm Formation and Antibiotic Resistant of Bacteria Isolated from Septic Neonates. J Med Chem Sci. 2023;6(4):816-826. doi: https://dx.doi.org/10.26655/JMCHEMSCI.2023.4.13.

[7] Setianingsih H, Ilmawan MF, Nawangsasi P. HBO's Impact on the Prevention and Therapy of Atherosclerotic Heart Disease through Matrix Metalloproteinase-12 (MMP-12) Expression. J Med Chem Sci. 2023;6(12):2867-2876. doi: https://doi.org/10.26655/JMCHEMSCI.2023.12.1.

[8] Dhivya R, Arun PD, Yachendra VSG, Surya R, Lakshmi R. Modified Lung Ultrasound Score to Determine the Degree of Perioperative Atelectasis in Adults Undergoing Elective Laparoscopic Surgery Under General Anaesthesia- A Prospective Observational Study. J Med Chem Sci. 2023;6(9):2104-2110. doi: https://doi.org/10.26655/JMCHEMSCI.2023.9.17.

[9] Rochayati I, Putra ST, Supriyatno B. Akurasi Pulse Oksimetri Fingertip Dibandingkan Pulse Oksimetri Generasi Baru dalam Deteksi Dini Penyakit Jantung Bawaan Kritis pada Bayi baru Lahir: Penelitian Pendahuluan. Sari Pediatr. 2016;17(2):113. doi: http://dx.doi.org/10.14238/sp17.2.2015.113-8.

[10] Levesque BM, Pollack P, Griffin BE, Nielsen HC. Pulse oximetry: What’s normal in the newborn nursery?. Pediatr Pulmonol. 2000;30(5):406–12. doi: https://doi.org/10.1002/1099-0496(200011)30:5<406::AID-PPUL7>3.0.CO;2-C.

[11] Akram NN, Abed MY. Indications and Outcome of Albumin Infusion in a Neonatal Population: A Cross Sectional Study. J Med Chem Sci. 2022;5(1):129-136. doi: 10.26655/JMCHEMSCI.2022.1.14.

[12] Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;8:307–10. doi: https://doi.org/10.1128/AAC.00483-18.

[13] Farhanah N, Supriadi S, Wahjono H, Hadisaputro S, Gasem MH. Predictors of Mortality in Sepsis Patients Resulting from Severe and Critical COVID-19. J Med Chem Sci. 2023;6(9):2018-2027. doi: https://doi.org/10.26655/JMCHEMSCI.2023.9.10.

[14] Schmitt HJ, Schuetz WH, Proeschel PA, Jaklin C. Accuracy of pulse oximetry in children with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth. 1993;7(1):61–5. doi: https://doi.org/10.1016/1053-0770(93)90120-A.

[15] Ewer AK, Middleton LJ, Furmston AT, Bhoyar A, Daniels JP, Thangaratinam S, et al. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): A test accuracy study. Lancet. 2011;378(9793):785–94. doi: http://doi.org/10.1016/S0140-6736(11)60753-8.

[16] Abiri S, Shiri AH, Jahromi MSS, Rayatdoost E, Afkhami H, Ravanshad R, Hosseini SE, Kalani N, Heidari P, Raoufi R. Safety and Efficacy of Popular Iranian Herbal Cold Remedy for COVID-19: A Randomized Clinical Trial in Mild to Moderate COVID-19 Cases. J Med Chem Sci. 2023;6(8):1799-1809. doi: https://doi.org/10.26655/JMCHEMSCI.2023.8.8.

[17] Poets CF, Wilken M, Seidenberg J, Southall DP, von der Hardt H. Reliability of a pulse oximeter in the detection of hyperoxemia. J Pediatr. 1993;122(1):87–90. doi: https://doi.org/10.1016/S0022-3476(05)83494-8.

[18] Schwartz BN, Hom LA, von Kohorn I, Becker J, Cuzzi SS, Grier Clarke SE, et al. Newborn pulse oximetry screening at a community hospital: An 8-year experience. Pediatrics. 2021;148(3). doi: https://doi.org/10.1542/peds.2020-049847.

[19] Secker C, Spiers P. Accuracy of pulse oximetry in patients with low systemic vascular resistance. Anaesthesia. 1997;52(2):127–30. doi: https://doi.org/10.1111/j.1365-2044.1997.32-az0062.x.

[20] Francis C, Kucinski A, Atalay L, Dar S, Shaat F. Pediatric Pulse Oximeter for Low Resource Countries. Honors Theses. 2001 :2538.

[21] Adibi P, Vatankhah M, Razavi BM, Fendereski F, Malekshoar M. Intravenous Pethidine versus Diclofenac Suppository in Shivering after Cesarean Section under Spinal Anesthesia. J Med Chem Sci. 2022;5(7):1142-1149. doi: https://doi.org/10.26655/JMCHEMSCI.2022.7.1.

[22] Susyanto BE, Puspita G, Suryanto S. A 5-year-old child with hemolytic anemia caused by glucose-6-phosphate dehydrogenase deficiency: a case report. Bali Med J. [Internet]. 2021 Dec. 30 [cited 2023 Aug. 4];10(3):1178-80. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/2877.

[23] Sanjaya INH, Pemayun CIM, Purwanti NWD, Sakuntari MDV, Gianni NPN, Putri NLMDMC, Pirgantari NKA, Satriani NLMDL, Mintariani FS, Padmawati NLPY, Putri AAW. Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report. Bali Med J. [Internet]. 2021 Jan. 25 [cited 2023 Aug. 4];10(1):8-10. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/2024.

[24] Shahnaz AA, Manggala Pasca Wardhana, Ernawati, Grace Ariani, Budi Utomo. Placental apoptotic index on COVID-19 and non-COVID-19 cases: a cross sectional study. Bali Med J. [Internet]. 2023 Mar. 3 [cited 2023 Aug. 4];12(1):916-20. Available from: https://www.balimedicaljournal.org/index.php/bmj/article/view/4200.

Intermittent pulse oximeter as a measurement of newborn oxygen: a cross-sectional study

Abstract

References

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