Oxygen Saturation In Children Research Articles

Pulse Oximetry Accuracy in Children with Dark Skin Tones: Relevance to Acute Lower Respiratory Infection Care in Low- and Middle-Income Countries.

Acute lower respiratory infections (ALRI) are the leading post-neonatal cause of death in children under 5 years old. There is a high prevalence of pediatric ALRI-related hypoxemia in low- and middle-income countries. The WHO defines clinically meaningful hypoxemia in children as a SpO2 (peripheral oxygen saturation) <90%. Multiple studies put this convention into question and found SpO2 of 90% to 92% to be associated with child ALRI mortality. An evolving body of evidence suggests that pulse oximeters systematically overestimate oxygen saturation in individuals with dark skin tones. We conducted a narrative review of pediatric studies evaluating pulse oximeter accuracy in children without COVID-19. Four studies, one prospective, examined pulse oximeter accuracy in children of varying ages with dark skin tones. All studies had limitations that affect their generalizability. There is evidence that certain pulse oximeters may overestimate oxygen saturation in children with dark skin tones. Further prospective research is urgently needed to identify affected populations and clinical implications. Despite recognized challenges, we strongly urge continued and expanded use of pulse oximetry as its use will save lives.

Hypoxoco-ischemic changes in bronchopulmonary dysplasia in premature children

Pulmonary pathology in children born prematurely, during infancy, is characterized by the peculiarities of nosological forms. Understanding and deciphering some pathogenetic mechanisms that contribute to the maintenance of hypoxia is extremely relevant [16].Material and methods. The principle of the modified ischemic albumin dosing method is based on the property of albumins to bind Co2+ ions, which determines the decrease in the color intensity of the solution, which is measured photometrically at 492 nm [23].Results. The analysis of the obtained results reveals a lower hemoglobin oxygen saturation in children with bronchopulmonary dysplasia compared to healthy children (by 2%, p=0.031), the differences being statistically true. The extent of the decrease is not major, but the data revealing cellular oxidative tendencies attest to a lack of oxygen compared to the needs of the cell. Conditions of hypoxia, ischemia, acidosis, as well as the exacerbation of free radical production cause the degradation of the N-terminal region of serum albumin with the formation of ischemic modified albumin (MIA). In our study, a statistically significantly higher level of serum AIM was recorded in children with bronchopulmonary dysplasia (by 74%, p&lt;0.001) compared to the values identified in children without DBP. Conclusions: In children with bronchopulmonary dysplasia, tissue hypoxic lesions can be evaluated by significantly increased MIA values, and their detection in chronic respiratory conditions is considered a useful diagnostic test.

Effect of Routine dental procedures on the pulse rate and peripheral oxygen saturation in pediatric patients

Dental treatment can cause anxiety in a child further leading to physiological changes that affects the success of dental care. This cross-sectional study was carried out to assess the changes in the pulse rate and peripheral oxygen saturation in children undergoing routine dental treatment. Total 80 patients of 6 to 12 years old were included in the study who were divided into four groups according the dental treatment they receive. Data was analyzed using SPSS-16. It was observed that the patients undergoing extraction (group IV) had higher mean pulse rate before, during and after the procedures; 100.25±9.33, 101.85±13.52, 98.85±7.63 respectively. Lowest SpO2 was recorded in the patients undergoing pulp therapy before the procedure (96.90±3.66). Pulse rate was higher in females compared to males but it was not statistically significant. The children in extraction group selecting facial image scale 4 had more mean pulse rate before during and after the procedure. The mean pulse rate was high in patients undergoing extraction in both first visit (103.00±9.21) and subsequent visits (101.36±15.28). It was concluded that physiological changes occur during routine dental treatment therefore monitoring should be done in order to prevent any dental emergencies.

Fisioterapi Dada terhadap Hemodinamik dan Saturasi Oksigen pada Anak dengan Pneumonia

This study aims to determine the effect of chest physiotherapy on hemodynamics (RR and HR) and oxygen saturation of children with pneumonia at Anutapura Hospital, Palu. This research uses quantitative research methods with this type of research using a quasi-experimental method with a two-group pre-post-intervention design. The results showed an effect of chest physiotherapy on hemodynamic status (HR and RR) and oxygen saturation in children with pneumonia at Anutapura Hospital, Palu, with a p-value &lt;0.05. In conclusion, there is a significant effect of implementing chest physiotherapy interventions on hemodynamic status (HR and RR) and oxygen saturation in children with pneumonia at Anutapura General Hospital, Palu &#x0D; Keywords: Toddlers, Chest Physiotherapy, Hemodynamics, Pneumonia, Oxygen Saturation

EFFECTS OF THE COVID-19 PANDEMIC ON CARDIOPULMONARY FUNCTION IN CHILDREN WITH CEREBRAL PALSY: A PRELIMINARY STUDY

The purpose of this study was to examine what effects the coronavirus disease 2019 (COVID-19) pandemic has on the cardiopulmonary endurance, heart rate and oxygen saturation in children with cerebral palsy (CP) during a 6-min walk test (6[Formula: see text]MWT). This study had a laboratory design and tested a single group pre- and post-COVID-19. A convenience sample of 8 participants with CP (three females; mean [Formula: see text] years) that was recruited from a community-based rehabilitation center was enrolled in the current study. Due to COVID-19, no rehabilitation was provided by a physical therapist for two months as the participants stayed at home. The descriptive statistics and paired [Formula: see text]-test were derived by examining the participants’ cardiopulmonary function via the Borg scale, 6[Formula: see text]MWT, heart rate and oxygen saturation, while they underwent rehabilitation versus the two months without rehabilitation due to COVID-19. The participants’ walking distances, oxygen saturation and heart rates were measured, and the Borg scale was used to assess the participants’ perceptions of their fatigue, breathlessness, and effort and exertion during the 6[Formula: see text]MWT. The descriptive statistical analysis demonstrated the following effects when comparing the post-COVID-19 results to those before the pandemic: greater distance on the 6 MWT test (0.69%), minimal changes in oxygen saturation ([Formula: see text]0.3%) and increased heart rate (8.4%) and Borg scale values (19.4%). Paired [Formula: see text]-test suggested that a significant difference was shown on the Borg scale ([Formula: see text]) and heart rate ([Formula: see text]). The results of this study provide clinical, evidence-based insights into the impact of the COVID-19 pandemic on cardiopulmonary function in children with CP. The clinical case series study demonstrated that after the COVID-19 pandemic, the participants with CP experienced increased heart rates and decreased minimal oxygen saturation, cardiopulmonary endurance. Recent advances in communication and information technology allow physical therapists to train and refine individually through remote rehabilitation. Exercise and combining VR remote education can be a way to maintain cardiopulmonary functions that have fallen due to the pandemic.

PREFACE: A SPECIAL SELECTION ON EMERGING TECHNIQUES FOR BIOMECHANICS–PART II

PREFACE: A SPECIAL SELECTION ON EMERGING TECHNIQUES FOR BIOMECHANICS–PART II

Comparing near-infrared spectroscopy-measured cerebral oxygen saturation and corresponding venous oxygen saturations in children with congenital heart disease: a systematic review and meta-analysis.

BackgroundNear-infrared spectroscopy (NIRS) is a non-invasive approach that measures cerebral regional oxygen saturation (rScO2). In this study, we evaluated the evidence on the validity of NIRS and the interchangeability between NIRS and common invasive approaches by exploring the correlation and consistency and comparing the mean and standard deviation between the NIRS rScO2 and jugular bulb venous oxygen saturation (SjvO2) as well as central venous oxygen saturation (ScvO2) in the perioperative period of children with congenital heart disease (CHD).MethodsWe searched electronic bibliographic databases (PubMed, The Cochrane Library and Embase) and screened the studies that met the inclusion criteria. We included cross-sectional studies of CHD pediatric patients in the perioperative period receiving both tests for NIRS rScO2 and SjvO2 or NIRS rScO2 and ScvO2. Methodological quality assessment and heterogeneity analyses were performed. We qualitatively summarized the results of Bland-Altman’s analysis. Meta-regression, subgroup analyses, and sensitivity analyses were carried out to explore the causes of heterogeneity.ResultsThere was no significant difference in Cohen’s d between rScO2 and ScvO2 or between rScO2 and SjvO2 (Cohen’s d =0.06, 95% CI: −0.16 to 0.28; Cohen’s d =0.03, 95% CI: −0.25 to 0.31, respectively) and notable heterogeneity existed (I2=76.0%, P<0.001; I2=73.6%, P<0.001, respectively). A positive linear correlation was present between rScO2 and ScvO2 or between rScO2 and SjvO2 (r=0.58, 95% CI: 0.54 to 0.63; r=0.60, 95% CI: 0.54 to 0.66, respectively) and the heterogeneity was not significant (I2=36.7%, P=0.065; I2=12.7%, P=0.328, respectively). In most studies, the 95% limits of agreements of Bland-Altman’s analysis were large. No evidence of publication bias was observed.ConclusionsThe rScO2 measured by NIRS reflected the SjvO2 and ScvO2 monitored by invasive measurements in the perioperative period of children with CHD to some extent. However, wide limits of agreements between rScO2 and SjvO2 as well as ScvO2 indicated that NIRS and SjvO2 as well as ScvO2 are not interchangeable. Whether NIRS plays a prominent role in monitoring cerebral oxygen saturation in children with CHD needs further research.

Rapid maxillary expansion in children, an update

Introduction: Rapid maxillary expansion (RME) increases oxygen saturation in children with Obstructive Sleep Apnea (OSA) in the short and long term. Objective: To analyze the current literature about rapid maxillary expansion, its effects on anatomical structures, midpalatal suture opening (MPS) and obstructive sleep apnea. Methodology: Articles published at MEDLINE/PubMed and Science Direct were analyzed, with an emphasis on the last 5 years. Articles were evaluated with the PRISMA and AMSTAR guidelines. The search was carried out using the words

Mask Use During Exercise Does Not Affect Oxygen Saturation in Children with or without Asthma

The differential effect of mask use during exercise on oxygen levels in children with and without asthma is unknown. We sought to measure peripheral oxygen saturation (SpO2) in children performing low-moderate intensity exercise.

Music Therapy Supports Children with Neurological Diseases during Physical Therapy Interventions.

Recent research found evidence supporting music therapy for children with neurological diseases during their hospitalized neurological early rehabilitation to promote their development during physical therapy. We hypothesized that live music therapy might improve vital signs during a physical therapy session. Seventeen children received live music therapy during the physical therapy session twice a week. Two more physical therapy sessions per week were held without music therapy. Heart rate, respiratory rate and oxygen saturation were recorded from 15 min before to 15 min after the therapy sessions. Physical therapy interventions showed changes in heart rate, respiratory rate and oxygen saturation between, before and after the sessions with or without music therapy. Live music therapy was effective for the vital signs during the intervention. We observed significantly lower heart and respiratory rates and higher oxygen saturation during physical therapy intervention with live music therapy in general (mean differences −8.0 beats per min; −0.8 breaths per min and +0.6%). When physical therapy was applied without music therapy children’s heart rates increased by 8.5 beats per min and respiratory rates increased by 1.0 breaths per min. Live music therapy leads to a decrease in heart and respiratory rates and an increase in oxygen saturation in children with neurological diseases during physical therapy with live music therapy. Music therapy supports the children in physical therapy interventions during their hospitalization.

Correlation between pulse oximetry and the clinical profile of children with acute lower respiratory tract infection

Background. Hypoxaemia is a common predictor of mortality and a potent marker of severe illness in children with acute lower respiratory tract infection (ALRTI). Objective. To determine the mean oxygen saturation (SpO2) in children with ALRTI and its correlation with selected clinical and anthropometric variables. Methods. A cross-sectional study of 178 children, aged between 2 months and 5 years, treated in two teaching hospitals in southeast Nigeria. All patients were assessed for ALRTI, focusing on their clinical profile and sociodemographic risk factors. Student’s t-test was used to compare means of discrete variables. Pearson correlation was used to express association between discrete variables and multiple regression was used to predict dependent variables. Results. Patients with severe ALRTI had significantly lower oxygen saturation (SpO2=89%) than those with mild disease (SpO2=95%) (p=0.001). A negative correlation was found between oxygen saturation and respiratory rate. Multiple regression analysis showed respiratory rate to be the only variable predicting oxygen saturation in children with ALRTI, with a negative association between the two variables. Conclusion. Low oxygen saturation is associated with decreased respiratory rate in children with ALRTI. Oxygen supplementation should always be considered in children with ALRTI, especially those with severe disease

THE OUTCOME OF PALLIATIVE STENTING IN CYANOTIC CONGENITAL HEART DISEASES

Objective: To determine the outcome of palliative stenting in children with cyanotic congenital heart diseases. Methodology: From February 2018 to October 2020, the Department of Paediatric Cardiology at Lady Reading Hospital in Peshawar conducted a cross-sectional study on patients who underwent right ventricular outflow tract blocked Blalock Taussig shunt stenting or patent ductus arteriosus stenting for cyanotic congenital heart disease. The patients' information was gathered using a pre-formatted proforma. Pre- and post-procedure oxygen satu­rations were recorded for 48 hours. The favorable outcome was defined as an increase in oxygen saturation of at least 15%. Results: The mean age of the sample (n=49) was 20±29 months. The etiology was Pulmonary Atresia (PA) with Patent ductus arteriosus (PDA) in 23 patients, followed by blocked Blalock Taussig Shunt (BT-Shunt) in 9 patients. The number of patients who underwent PDA stenting was 32, 9 patients had stenting of blocked BT-Shunt and 8 patients had RVOT stenting. The mean pre-intervention oxygen saturation was 43% ±8.9% and the mean post-in­tervention oxygen saturation was 81% ±5.3%. The number of patients who died was 2, one patient for RVOT stenting died on the table due to cyanotic spell while other post-PDA stenting died because of stent thrombosis. Conclusion: RVOT, Patent Ductus arteriosus, and blocked Blalock Taussig shunt stenting was found effective in increasing oxygen saturation in children with cyanotic PDA.

Higher preoperative Qp/Qs ratio is associated with lower preoperative regional cerebral oxygen saturation in children with ventricular septal defect

The relationship between regional cerebral oxygen saturation (rSO2) and the amount of left-to-right shunt in ventricular septal defect (VSD) patients has not yet been investigated. The purpose of this study was to identify the association of preoperative pulmonary to systemic blood flow (Qp/Qs) ratio and preoperative rSO2 in patients with VSD. We retrospectively evaluated 49 VSD surgical closure candidates at a single institution. Preoperative Qp/Qs ratio was compared with rSO2 measurements at the time of VSD closure surgery. Forty-nine were eligible for the final analysis. The median age at surgery was 6 (interquartile range [IQR]: 3, 12) months, and 36.7% were male. Atrial septal defects coexisted in 51.0%. There were no genetic abnormalities except trisomy 21 in 32.6% of the patients. Pulmonary hypertension was found in 42.8%. The median Qp/Qs ratio, calculated based on catheter testing results before the surgery, was 2.7 (IQR: 2.1, 3.7). Postoperative rSO2 was significantly higher than preoperative values (52.2 ± 12.9, 63.5 ± 13.1%, p < 0.001). There was an inverse relationship of Qp/Qs and preoperative cerebral rSO2 (r = -0.11, p = 0.02). A higher Qp/Qs ratio was associated with a lower preoperative cerebral rSO2 in pediatric patients with VSD.

Postoperative Cerebral Oxygen Saturation in Children After Congenital Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective Observational Study.

During the early postoperative period, children with congenital heart disease can suffer from inadequate cerebral perfusion, with possible long-term neurocognitive consequences. Cerebral tissue oxygen saturation can be monitored noninvasively with near-infrared spectroscopy. In this prospective study, we hypothesized that reduced cerebral tissue oxygen saturation and increased intensity and duration of desaturation (defined as cerebral tissue oxygen saturation < 65%) during the early postoperative period, independently increase the probability of reduced total intelligence quotient, 2 years after admission to a PICU. Single-center, prospective study, performed between 2012 and 2015. The PICU of the University Hospitals Leuven, Belgium. The study included pediatric patients after surgery for congenital heart disease admitted to the PICU. None. Postoperative cerebral perfusion was characterized with the mean cerebral tissue oxygen saturation and dose of desaturation of the first 12 and 24 hours of cerebral tissue oxygen saturation monitoring. The independent association of postoperative mean cerebral tissue oxygen saturation and dose of desaturation with total intelligence quotient at 2-year follow-up was evaluated with a Bayesian linear regression model adjusted for known confounders. According to a noninformative prior, reduced mean cerebral tissue oxygen saturation during the first 12 hours of monitoring results in a loss of intelligence quotient points at 2 years, with a 90% probability (posterior β estimates [80% credible interval], 0.23 [0.04-0.41]). Similarly, increased dose of cerebral tissue oxygen saturation desaturation would result in a loss of intelligence quotient points at 2 years with a 90% probability (posterior β estimates [80% credible interval], -0.009 [-0.016 to -0.001]). Increased dose of cerebral tissue oxygen saturation desaturation and reduced mean cerebral tissue oxygen saturation during the early postoperative period independently increase the probability of having a lower total intelligence quotient, 2 years after PICU admission.

Effects of fast-tracking anesthesia on the surgical efficacy and cerebral oxygen saturation of children with congenital heart disease.

Effects of fast-tracking anesthesia on the surgical efficacy and cerebral oxygen saturation of children with congenital heart disease.

Evaluation and selection of high-frequency chest wall oscillation modes in children with community-acquired pneumonia based on pulse oximetry

The high-frequency chest wall oscillation (HFCWO) is a method of airway clearance therapy, which helps to restore the drainage function of the bronchial glands, improve the pulmonary function and pulmonary gas exchange in children with cystic fibrosis, atelectasis, and bronchiectasis.Aim: to select effective modes of high-frequency chest wall oscillation for increase oxygen saturation in children with community-acquired pneumonia based on pulse oximetry data.Materials and methods. The selection and evaluation of the HFCWO modes were performed in 261 children (girls – 47.1 % and boys – 52.9 %) aged 6–17 years with a moderate degree and acute course of community-acquired pneumonia (CAP) using eight oscillation modes of the Vest Airway Clearance System, Model 105. The effectiveness of the HFCWO modes was assessed on the 1st and 10th day of the disease by measuring the degree of arterial hemoglobin oxygen saturation (SpO2) using noninvasive transmission pulse oximetry with the use of a pulse oximeter, Series YX 300. The ROC analysis was performed, the area under the ROC curve (AUC) was presented with the associated 95 % confidence interval (CI).Results. According to a comparison of the sensitivity and specificity of the ROC analysis method, the 1st mode of HFCWO is recommended to apply for preschool children of asthenic somatotype, which is confirmed by the highest AUC – 0.95 (95 % CI 0.86–1.00). The 2d mode of HFCWO should be included in the complex therapy for preschool children of normosthenic somatotype, which is confirmed by the highest AUC – 0.94 (95 % CI 0.88–1.00). For prepubertal children of asthenic somatotype the 3rd mode of HFCWO should be used based on the highest value of AUC – 0.93 (95 % CI 0.81–1.00). For prepubertal children of normosthenic somatotype, we recommend including the 4th mode of HFCWO with an AUC value of 0.94 (95 % CI 0.84–1.00) in the comprehensive treatment of CAP. Regarding the adolescents of asthenic somatotype, we recommend applying the 5th mode of HFCWO, the AUC of which is 0.97 (95 % CI 0.91–1.00). As for the adolescents of normosthenic somatotype, the 6th mode of HFCWO should be used based on the AUC– 0.98 (95 % CI 0.91–1.00).Conclusions. To increase the effectiveness of community-acquired pneumonia treatment, it is necessary to include HFCWO in the daily therapy taking into account the optimal oscillation parameters. Modes 1-6 of HFCWO influence the level of oxygen saturation, improving it. It is recommended to use sparing oscillation modes (1, 3 and 5) for children with asthenic somatotype in complex therapy of pneumonia compared to children with normosthenic somatotype.

Anti-inflammatory medications for obstructive sleep apnoea in children.

Anti-inflammatory medications for obstructive sleep apnoea in children.

The Effects of Acupressure on Physiological Indicators of Pain in Children Undergoing Tonsillectomy: A Randomized, Single-Blind, Placebo-Controlled Trial Study

Background: Tonsillectomy is regarded as one of the most commonly used pediatric surgical procedures whose anxiety-related consequences can bring about several changes in the physiological characteristics of children. Therefore, the use of low-cost anxiety-relieving techniques in this domain can be of utmost importance to stabilize vital signs in this age group. Objectives: Accordingly, the purpose of the present study was to investigate the effects of acupressure on physiological indicators of pain including respiratory rate, heart rate, and levels of arterial oxygen saturation in children undergoing tonsillectomy. Methods: This study was a three-group single-blind clinical trial conducted on 144 children aged five to 12 years undergoing a tonsillectomy. To this end, the subjects were allocated into three groups of 48 individuals including control, intervention, and placebo ones. In this respect, the intervention (experimental) group received acupressure applied to three pressure points three times a day for one hour, two to four hours, and six to eight hours following a tonsillectomy. However, in the placebo group, acupressure was applied to a false (sham) acupoint. The control group also received only routine care services. Before and after all three phases of the intervention, the physiological indicators of pain (heart and respiratory rate, blood pressure) were measured and recorded in all three study groups. The data were finally analyzed using descriptive statistics (mean and standard deviation) and inferential ones (Wilcoxon signed-rank test, chi-square test, one-way analysis of variance (ANOVA), and Kruskal-Wallis test). Results: The results of this study revealed significant differences in heart rate (P = 0.001), respiratory rate (P = 0.001), and levels of arterial oxygen saturation (P = 0.001) after three intervals of acupressure in the intervention group compared to those in other two groups. Accordingly, the means of heart rate and respiratory rate decreased and the levels of arterial oxygen saturation increased in the intervention group indicating a small number of fluctuations and much more balance in physiological indicators of pain. Conclusions: The findings of the present study showed that parasympathetic activity, following acupressure in the intervention group, could cause several changes in physiological responses, and also create a sense of relief and moderate anxiety in children. Therefore, anxiety in children undergoing a tonsillectomy could be lowered with the use of a simple, low-cost, and non-invasive technique contributing to the maintenance of physiological indicators of pain as well as decreased complications driven by vital signs, not in a normal range.

Pulse oximetry in comparison to arterial blood oxygen saturation in children with bronchial asthma coming to the emergency room

Background Bronchial asthma is currently defined as a chronic inflammatory disorder of the airways. Hypoxia is a universal finding in acute exacerbations of asthma. However, respiratory failure with PaO2 below 60 mmHg or PaCO2 above 45 mmHg occurs in no more than one-third of patients. Pulse oximetry allows noninvasive measurement of arterial oxygen saturation (SpO2), without the risks associated with arterial puncture. Aim The aim of this study was to evaluate pulse oximetry as a valid tool to predict respiratory failure in children with acute severe attack of bronchial asthma as compared with the standard arterial blood gas (ABG) analysis. Patients and methods The study was carried out on 50 children, 30 of them were patients with acute bronchial asthma and 20 of them were healthy controls. All patients and controls were subjected to the following: Full history taking, clinical examination such as pulse oximetry and investigations which included chest radiography, echocardiography, and ABG analysis. Results There was no significant difference between asthmatic and control groups regarding age, sex, weight, and height. We found that respiratory rate and heart rate was higher in asthmatic patients than controls. We demonstrated a negative correlation between PaCo2 and SPO2 and between PaO2 and PaCO2, and a positive correlation between SaO2 and SPO2 and between PaO2 and SPO2. Oxygen saturation measured by pulse oximetry (SpO2) was greater than oxygen saturation measured by the ABG analyzer, but this difference was not statistically significant. Conclusion Arterial oxygen saturation measured by pulse oximetry can be used as a tool to diagnose respiratory failure in an emergency setting where ABG facility in not available.

Cerebral Oxygen Saturation in Children With Congenital Heart Disease and Chronic Hypoxemia.

Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE). This study investigated the associations of ScO2 and ΔSaO2-ScO2 with SaO2 and Hb and verified the normal range of ScO2 in children with CHD. Children undergoing cardiac catheterization for CHD were enrolled in a calibration and validation study of the FORE-SIGHT NIRS monitor. Two pairs of simultaneous arterial and jugular bulb samples were drawn for co-oximetry, calculation of a reference ScO2 (REF CX), and estimation of COE. Pearson correlation and linear regression were used to determine relationships between O2 saturation parameters and Hb. Data were also analyzed according to diagnostic group defined as acyanotic (SaO2 ≥ 90%) and cyanotic (SaO2 < 90%). Of 65 children studied, acceptable jugular bulb samples (SjbO2 absolute difference between samples ≤10%) were obtained in 57 (88%). The ΔSaO2-SjbO2, ΔSaO2-ScO2, and ΔSaO2-REF CX were positively correlated with SaO2 and negatively correlated with Hb (all P < .001). Although by diagnostic group ScO2 differed statistically (P = .002), values in the cyanotic patients were within the range considered normal (69% ± 6%). COE estimated by the difference between arterial and jugular bulb O2 content (ΔCaO2-CjbO2, mL O2/100 mL) was not different for cyanotic and acyanotic patients (P = .10), but estimates using ΔSaO2-SjbO2, ΔSaO2-ScO2, or ΔSaO2-ScO2/SaO2 were significantly different between the cyanotic and acyanotic children (P < .001). Children with adequately compensated chronic hypoxemia appear to have ScO2 values within the normal range. The ΔSaO2-ScO2 is inversely related to Hb, with the implication that in the presence of reduced Hb, particularly if coupled with a decreased cardiac output, the ScO2 can fall to values associated with brain injury in laboratory studies.