Intermittent pulse oximeter as a measurement of newborn oxygen: a cross-sectional study

Introduction: Intermittent monitoring using fingertip pulse oximeters is increasingly being used in guiding oxygen therapy and screening congenital heart defects in newborns. However, there are no evidence-based guidelines for using fingertip pulse oximeters for intermittent monitoring of newborns in low-resource settings. This research assesses the validity of the fingertip pulse oximeter to measure oxygen saturation in newborns against the continuous monitoring pulse oximeter as a standard method. Method: A prospective study was conducted in the NICU and Neonatal Intermediate Unit of Dr. Soetomo Academic Hospital Surabaya. Newborns aged below 28 days using a respiratory device were included. Oxygen saturation measurements using a continuous monitoring pulse oximeter and intermittent pulse oximeter were done on the right hand and both feet. Paired t-test and Bland-Altman plot was performed to assess the validity. Results: Eighty-five neonates were included. There is an agreement between Intermittent and continuous pulse oximeters in the normoxic group with a limit of agreement -1.29 (CI 95% -1.62 to -0.95) to 1.29 (CI 95% 0.95 to 1.62) and hypoxic group with a limit of agreement -3.36 (CI 95% -4.29 to -2.44) to 3.00 (CI 95% 2.08 to 3.92). Intermittent pulse oximeter measurement requires a longer time for maximum results compared to continuous pulse oximeter (p=0.001). Conclusions: The intermittent pulse oximeter is available to be used alternately with a continuous pulse oximeter. However, it has limitations in hypoxemia settings, hence the application in real-time clinical practice needs further study.