Abstract
Continuous monitoring of arterial oxygen saturation by pulse oximetry (SpO2) is the main method to guide respiratory and oxygen support in neonates during postnatal stabilization and after admission to neonatal intensive care unit. The accuracy of these devices is therefore crucial. The presence of fetal hemoglobin (HbF) in neonatal blood might affect SpO2 readings. We performed a systematic qualitative review to investigate the impact of HbF on SpO2 accuracy in neonates. PubMed/Medline, Embase, Cumulative Index to Nursing & Allied Health database (CINAHL) and Cochrane library databases were searched from inception to January 2021 for human studies in the English language, which compared arterial oxygen saturations (SaO2) from neonatal blood with SpO2 readings and included HbF measurements in their reports. Ten observational studies were included. Eight studies reported SpO2-SaO2 bias that ranged from −3.6%, standard deviation (SD) 2.3%, to +4.2% (SD 2.4). However, it remains unclear to what extent this depends on HbF. Five studies showed that an increase in HbF changes the relation of partial oxygen pressure (paO2) to SpO2, which is physiologically explained by the leftward shift in oxygen dissociation curve. It is important to be aware of this shift when treating a neonate, especially for the lower SpO2 limits in preterm neonates to avoid undetected hypoxia.
Highlights
PubMed/Medline, Embase, Cumulative Index to Nursing & Allied Health database (CINAHL) and Cochrane library databases were searched from inception to January 2021 for human studies in the English language, which compared arterial oxygen saturations (SaO2) from neonatal blood with SpO2 readings and included HbF measurements in their reports
Continuous arterial oxygen saturation measured by pulse oximetry (SpO2) is the primary monitoring to guide respiratory and oxygen support in neonates during postnatal stabilization and after admission to a neonatal intensive care unit (NICU) [1,2]
A systematic search of Pubmed/Medline, Embase, Cumulative Index to Nursing & Allied Health (CINAHL) and Cochrane library was performed from the date of inception of the databases to January 2021 to identify articles that concerned HbF and oxygen saturation monitoring by pulse oximetry in term and preterm neonates
Summary
Continuous arterial oxygen saturation measured by pulse oximetry (SpO2) is the primary monitoring to guide respiratory and oxygen support in neonates during postnatal stabilization and after admission to a neonatal intensive care unit (NICU) [1,2]. In order to establish the pulse oximeter’s measure of SpO2, the ratio of absorbance at these wavelengths is calculated and calibrated against direct measurements of arterial oxygen saturation from blood samples (SaO2). For this purpose, blood samples are taken from healthy adult volunteers under room air (normoxemia) and in artificially acquired hypoxic environments to achieve hypoxemia [8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
