Stebbens V A, Poets C F, Alexander J R, Arrowsmith W A, Southall D P
Department of Paediatrics, National Heart and Lung Institute, Brompton Hospital, London.
Arch Dis Child. 1991 May;66(5):569-73. doi: 10.1136/adc.66.5.569.
Overnight 12 hour tape recordings were made of arterial oxygen saturation (SaO2, pulse oximeter in the beat to beat mode) and abdominal wall breathing movement on 67 healthy, full term infants between the ages of 29 and 54 (median 39) days. The median baseline SaO2 during regular breathing was 99.8% (range 97.0-100%). Fifty four infants (81%) had shortlived episodes during which SaO2 fell to 80% or less (desaturation); the median rate was 0.9 desaturations/hour, and the median duration of each desaturation was 1.2 seconds. The 97th centile value for the duration of all episodes in which SaO2 fell to less than or equal to 80% was 4.0 seconds. The frequency of desaturations was significantly higher, and their duration significantly longer, when the breathing pattern was non-regular rather than regular. The percentage of apnoeic pauses (greater than or equal to 4 seconds in duration) followed by a desaturation was higher during non-regular than regular breathing; it was particularly high during periodic breathing. A knowledge of normal variability of baseline measurements of oxygenation and of the relationship between oxygenation and breathing patterns in infants is essential to the use of pulse oximetry in clinical practice.
对67名年龄在29至54天(中位数为39天)的健康足月儿进行了为期12小时的夜间动脉血氧饱和度(SaO2,采用逐搏模式的脉搏血氧仪)和腹壁呼吸运动的磁带记录。正常呼吸时的基线SaO2中位数为99.8%(范围为97.0 - 100%)。54名婴儿(81%)出现过短暂的血氧饱和度降至80%或更低的情况(血氧饱和度降低);发生率中位数为每小时0.9次,每次血氧饱和度降低的持续时间中位数为1.2秒。所有血氧饱和度降至小于或等于80%的发作持续时间的第97百分位数为4.0秒。当呼吸模式不规律而非规律时,血氧饱和度降低的频率显著更高,且持续时间显著更长。不规律呼吸时,继血氧饱和度降低之后出现的呼吸暂停(持续时间大于或等于4秒)的百分比高于规律呼吸时;在周期性呼吸时尤其高。了解婴儿氧合基线测量的正常变异性以及氧合与呼吸模式之间的关系对于临床实践中使用脉搏血氧仪至关重要。