Iowa Neonatology Handbook: Pulmonary

Surveillance of pH and Blood Gas Status of Neonates

Edward F. Bell, MD and Jonathan M. Klein, MD
Peer Review Status: Internally Peer Reviewed

 I. Hyperoxemia: Due to the persistent, continuing incidence of retinopathy of prematurity (ROP), any premature infant < 34 weeks gestation who is in an increased ambient oxygen concentration must have his/her arterial oxygen tension monitored. However, ROP has been noted in infants whose PaO2 have not been higher than 100mmHg. Furthermore, efforts aimed at avoiding hyperoxemia in term and preterm neonates are indicated in most clinical conditions with the possible exception of pulmonary hypertension (persistent fetal circulation).

II. Hypoxemia: Although rigorous clinical studies have not defined precise limits, hypoxemia has been associated with IVH, PFC, and poor neurologic outcome. Hypoxemia(PaO2 values below 45-50 mmHg), and acidosis (pH < 7.20), are to be avoided since both have been associated with reopening of the ductus arteriosus leading to increased pulmonary vascular resistance, decreased pulmonary perfusion, and further hypoxemia.

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