Episodes of spontaneous desaturations in infants with chronic lung disease at two different levels of oxygenation

The optimal range of pulse oximeter oxygen saturation (Sao₂) for infants with chronic lung disease (CLD) has not been well established. We quantified episodes of spontaneous desaturation, at two different ranges of Sao₂. For 1 hr each, we alternatively administered inspired O₂ concentrations (Fio₂, necessary to maintain an Sag of 94–96% or 87–91% to 21 patients (mean birth weight, 865 g; gestational age, 27.3 weeks; postnatal age 40.6 days) with CLD (defined by Fio₂ > 0.21 at ≥ days and radiographic evidence). Sao₂ was monitored with the Nellcor N‐200 oximeter and analyzed by a computer program (SatMaster). The percentage of time the infants desaturated to levels of Sao₂ <85 and <80% revealed significantly fewer spontaneous episodes during the hour of higher baseline Sao₂ (P < 0.0002). Comparison of episodes of spontaneous desaturation to Sao₂ < 80 and <85%, lasting 0–15, 16–30, 31–45 sec also showed significant differences between the two levels of Sao₂. We conclude that when Infants with CLD are maintained at a higher Sao₂ they probably experience fewer episodes of spontaneous desaturations, because of less alveolar hypoxia. We bell that attempts at weaning the Fio₂ should be tempered with the need of maintaining an adequate Sao₂. Therefore, prolonged monitoring of oxygenation in infants with CLD at different levels of Sao₂ could be helpful during the weaning process. Pediatr Pulmonol. © 1993 Wiley‐Liss, Inc.