Abstract
The sleeping quiescent fetus develops in an environment of low, relatively stable oxygen tension. The premature, sick, sleep deprived (?) newborn struggles to survive in a chaotic oxygen environment. Continuous monitoring of transcutaneous O2 tension reveals that events such as feeding, crying, suctioning, blood sampling, noise, handling, apnea, restlessness, diaper changes, chest P. T., physical exams, etc., result in profound drops in arterial oxygen tension. Our hypothesis is that the stress of “intensive care” examinations, nursing care and diagnostic studies interrupt the sleeping state, cause episodes of apnea, disorganized ineffective breathing, apnea and hypoxia, which in turn lead to more handling and diagnostic studies. We question the usefulness of present techniques for monitoring respiration. They are neither adequate for detecting nor preventing hypoxia and may actually interfere with the normal maturation of respiratory control. Unnecessary hypoxic stresses, identified by continuous tcPO2 monitoring, should be avoidable through simple changes in techniques of care. Similarly, episodes of hyperoxia can be minimized.
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Lucey, J., Peabody, J. & Philip, A. RECURRENT UNDETECTED HYPOXIA AND HYPEROXIA, A NEWLY RECOGNIZED IATROGENIC PROBLEM OF “INTENSIVE CARE”. Pediatr Res 11, 537 (1977). https://doi.org/10.1203/00006450-197704000-01001
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DOI: https://doi.org/10.1203/00006450-197704000-01001
