Purpose: The aim of this study was to examine the accuracy of arterial oxygen saturation (SaO2) and venous oxygen saturation (SvO2) with paired arterial and venous (AV) blood in relation to pulse oximetry saturation (SpO2) and oxyhemoglobin (HbO2) with fetal hemoglobin determination, and their HbO2 dissociation curves. Method: Twelve preterm neonates with gestational ages ranging from 27 to 34 weeks at birth, who had umbilical AV lines inserted, were investigated. Analyses were performed with 37 pairs of AV blood samples by using a blood volume safety protocol. Results: The mean differences between SaO2 and SvO2, and AV HbO2 were both 6 percent (±6.9 and ±6.7 percent, respectively), with higher SvO2 than those reported for adults. Biases were 2.1 ± 0.49 for SaO2, 2.0 ± 0.44 for SvO2, and 3.1 ± 0.45 for SpO2, compared against HbO2. With left-shifted HbO2 dissociation curves in neonates, for the critical values of oxygen tension values between 50 and 75 millimeters of mercury, HbO2 ranged from 92 to 93.4 percent; SaO2 ranged from 94.5 to 95.7 percent; and SpO2 ranged from 93.7 to 96.3 percent (compared to 85-94 percent in healthy adults). Conclusions: In neonates, both left-shifted HbO2 dissociation curve and lower AV differences of oxygen saturation measurements indicated low flow of oxygen to the body tissues. These findings demonstrate the importance of accurate assessment of oxygenation statues in neonates.
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