947 USE OF TRANSCUTANEOUS OXYGEN (tcPo2) MONITORING DURING INFANT TRANSPORT

Abstract

During transport from outlying hospitals, critically ill neonates may be exposed to inappropriate levels of oxygen for prolonged periods. This study was undertaken to determine the feasibility and usefulness of tcPo2 monitoring during transport of infants with respiratory diseases. A standard Roche 5301 oxygen monitor was powered by a portable battery/AC-DC inverter system. The electrode drift was less than 2% for periods up to 120 min. with no interference in recording from ambulance motion. The skin electrode was placed on an infant's thigh immediately after arrival at the referring hospital. Seven infants, gestational age 28-41 weeks, birth weight 820-3490 gm, four of whom required intubation and ventilation, were evaluated. The tcPo2 ranged from 48-98 torr on initial reading at the referring hospital, providing an objective assessment of the infant's oxygenation. With the transcutaneous monitor the F1O2 could be adjusted rapidly to required levels and adequate assisted ventilation established when needed. Unstable infants were identified readily by the large change in tcPo2 with minimal handling. Paired values of tcPo2 & Pao2 were within ±10 torr (range Pao2 42-112) in 70% of measurements. In 3 patients the tcPo2 readings remained in an adequate therapeutic range throughout transport. Two patients had significant lowering (greater than 40 torr) of tcPo2 from various procedures during transport. In summary, we have found tcPo2 monitoring useful during transport of unstable ill infants.