995 A COMPARISON OF TRANSCUTANEOUS OXYGEN (TcPO₂) MONITORING AND CONVENTIONAL TECHNIQUES FOR DETECTING HYPEROXEMIA AND HYPEROXEMIA

Abstract

Non-invasive, continuous TcPO₂ monitoring has revealed that neonatal arterial O₂ tension is very labile and is inadequately monitored by periodic arterial oxygen sampling and apnea monitoring with impedance pneumography. “Intensive care” results in multiple diagnostic, therapeutic and nursing procedures, many of which cause hypoxemia unsuspected and undetected by present techniques. Our hypothesis is that continuous TcPO₂ monitoring will minimize “iatrogenic” hypoxemia and hyperoxemia. To date we have studied 15 conventionally monitored infants (780-2280 grams,. 28-36 weeks) and 15 TcPO₂ monitored infants (1030-2380 grams, 29-36 weeks). We have found that infants in our nursery are handled 50-52 times in a 20-hour period, 10% of these handlings result in a drop of TcPO₂ of greater than 20 torr and recovery takes 4.4 minutes per episode. A mean time of 40 min. per 20 hours was spent in an “undesirable” range (TcPO₂ less than 40 torr or greater than 100). Fifty-two per cent of this “undesirable time” was associated with iatrogenic disturbances. Blood gases and apnea monitors detected less than 5% of this undesirable time. Our present study is being extended to determine if this “undesirable time” can be reduced or eliminated by using continuous TcPO₂ monitoring to indicate where the timing and number of diagnostic and therapeutic procedures can be beneficially modified.

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