CLINICAL STUDY OF NEONATES RECEIVING OXYGEN THERAPY AND THEIR OUTCOMES
Abstract
Oxygen administration is a common therapy in neonatal nurseries.1
Many neonates who get admitted in SNCU OR NICU receive oxygen therapy. Common clinical situations in which baby needs oxygen 2:-
1. Need for resuscitation at birth
2. Birth asphyxia
3. Respiratory distress
4. Hypoxemia (SpO2 <87% or paO2 <50 mm of Hg) in room air
5. Cyanosis
6. Hypothermia
7. Recurrent apneic attacks
Hypoxemia as well as hyperoxemia3, 4 are harmful to the baby. SpO2 alone is not always indicative of adequacy of oxygen therapy.
In a study oxygen therapy each year over 5,000 infants (~ 2% of all infants born) in Australia receive oxygen therapy during their initial stay in a neonatal nursery and almost 300 of these infants required continued oxygen therapy at
home after discharge5.
The incidence of oxygen therapy is dependent on gestational age at birth with 97% of 7 27 weekers receiving supplemental oxygen, whilst 79% of 28-31 weekers receive oxygen therapy during their initial hospitalisation5.
If one could identify the preventable risk factors it would help to anticipate and intervene early for a better outcome.
Among neonates needing oxygen therapy, outcome depends not only on optimum oxygen therapy [SpO2 88-92% with lower and upper limits 85-95%] but
also on clinical condition and biological maturity. Outcome determinants may differ from place to place.
If one can identify factors contributing to negative clinical outcome despite optimum oxygen therapy it will help improve management in addition to oxygen therapy.
Keywords
Full Text:
PDFReferences
Bakwin H. Oxygen therapy in premature babies with anoxemia. Am J Dis Child. 1923; 25: 157-192.
Meharban Singh .Care of the new born:Miscellaneous conditions.7thedition.New Delhi :Sagar publications;2010.
AskieLM , et al. Restricted versus liberal oxygen exposure for preventing morbidity and mortality in preterm or low birth weight infants . Cochrane database of systematic reviews 2009; 1: CD 001077.
Benjamin J. Stenson , Judith A.Orme .The twists and turns of neonatal oxygen therapy. 2012 Dec; 88(12):961-963 .
Donoghue DA, Cust AE. The Australian and New Zealand Neonatal Network, 1999. Sydney: AIHW National Perinatal Statistics Unit. p30-31.
Am J Crit Care. Validation of oxygen saturation monitoring in neonates.2007 Mar;16 (2):168-178.
Poets CF. When do infants need additional inspired oxygen? A review of the current literature. PediatrPulmonol. 1998; 26: 424-428.
Castillo A, Sola A, Baquero H, Neira F, Alvis R, Deulofeut R, Critz A .Pulse oxygen saturation levels and arterial oxygen tension values in newborns receiving oxygen therapy in the neonatal intensive care unit: is 85% to 93% an acceptable range?.2008 May;121(5): 882-889.
John K attwinkel, LynnJ.Cook, Hallam Hurt , et al .Perinatal Continuing Education Programe Neonatal Care.2nd Edition .USA :Jaypee Publications; 2012.
BCYelamali,PushpaPanigatti, et al,: Outcome of newborn with birth asphyxia in tertiary care hospital. December 2014, volume 3, issue 2.
Rehanamajeed, et al, :Risk factors of birth asphyxia.J Ayub Med Coll Abbottabad 2007; 19(3).
KeertiSwarnkar and Manish Swarnkar / International Journal of Biomedical and Advance Research 2015; 6(09): 643-647.
ShaziaMemon, et al, : To compare the outcome (early) of neonates with birth asphyxia in-relation to place of delivery and age at time of admission. J Pak Med Assoc Vol. 62, No.12, December 2012.
Nilufarshireen, et al,:Risk Factors and Short-Term Outcome of Birth Asphyxiated Babies in Dhaka Medical College Hospital.Bangladesh J child health 2009; VOL 33 (3): 83-89.
John BM, Venkateshwar V, Dagar V. Predictors of Outcome in Neonates with Respiratory Distress. J Nepal PaediatrSoc 2015;35(1):31-37.
Hafiz Muhammad Aslam, et al, :Risk factors of birth asphyxia. Aslam et al.Italian Journal of
Pediatrics. 20 December 2014.
Lee AC, Mullany LC, Tielsch JM, Katz J, Khatry SK, LeClerq SC, Adhikari RK, Shrestha SR, Darmstadt GL: Risk factors for neonatal mortality due to birth asphyxia in southern Nepal: a prospective, community-based cohort study. Pediatrics 2008, 121(5):e1381–e1390
BahubaliGane, et al, :Antenatal and intrapartum risk factors for perinatal asphyxia: A case control study. CurrPediatr Res 2013; 17 (2): 119-122.
Jing Liu, et al, :High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study. Balkan Med J, Vol. 31, No. 1, 2014.
Barkiya SM, Venugopal N, Kumari V. Clinico-Etiological Profile and Outcome of Neonatal Respiratory Distress. IntJ Sci Stud 2016;3(11):189-192.
Jung-Hwan Choi, Won Soon Park, Chong Ku Yun.Correlation between Pulse Oximetry Oxygen Saturation (SpO2) and Measured Arterial Oxygen Saturation (SaO 2) and Arterial Oxygen Tension (PaO2) in Neonates.The Seoul Journal of Medicine Vol. 32, No. 1: 17-25, March 1991.
Deckardt R, Steward DJ. Noninvasive arterial hemoglobin oxygen saturation versus transcutaneous oxygen tension monitoring in preterm infant. Crit. Care Med. 1984, 12: 935-939.
Durand M, Ramanathan R. Pulse oximetry for continuous oxygen monitoring in sick newborn infants. J. Pediatr. 1986, 109: 1052-1056.
Harris AP, Sendak MJ, Donham RT. Changes in arterialsaturation immediately after birth in the delivery room by pulse oximetry. J. Pediatr. 109: 117-119.
House JT, Schultetus RR, Gravenstein N. Continuous neonatal evaluation in the delivery room by pulse oximetry. J. Clin. Monit. 1987, 3: 96-100,
Fanconi S. Reliability of pulse oximetry in hypoxic infants. J. Pediatr. 1988, 1 12: 424-427.
Peabody JL, Emery JR. Noninvasive monitoring of blood gases in the newborn. Clin. Perinatol. 1985, 12: 147-160.
Ramanathan R, Durand M, Larrazabal C. Pulse oximetry in very low birth weight infants with acute and chronic lung disease. Pediatrics 1987, 79: 6 12- 617.
Hay WW Jr, Brockway, JmEyzaguirre.M. Neonatal pulse oximetry: Accuracy and reliability, Pediatrics 1989; 83:717.
Refbacks
- There are currently no refbacks.