HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (11) Citing Articles via Google Scholar Google Scholar Articles by Brouillette, R. T. Articles by Waxman, D. H. Search for Related Content PubMed PubMed Citation Articles by Brouillette, R. T. Articles by Waxman, D. H. Related Collections Laboratory Management Pediatric Clinical Chemistry Drug Monitoring and Toxicology

Evaluation of the newborn's blood gas status

The Department of Pediatrics, McGill University/Montreal Children's Hospital, Montreal, QC, Canada.
^a Address correspondence to this author at: 2300 Tupper St., C-920, Montreal, QC, Canada H3H 1P3. Fax 514-934-4356; e-mail rbronew{at}newborn.mchis.mcgill.ca

Blood gas measurements and complementary, noninvasive monitoring techniques provide the clinician with information essential to patient assessment, therapeutic decision making, and prognostication. Blood gas measurements are as important for ill newborns as for other critically ill patients, but rapidly changing physiology, difficult access to arterial and mixed venous sampling sites, and small blood volumes present unique challenges. This paper discusses considerations for interpretation of blood gases in the newborn period. Blood gas measurements and noninvasive estimations provide important information about oxygenation. The general goals of oxygen therapy in the neonate are to maintain adequate arterial P_aO₂ and S_aO₂, and to minimize cardiac work and the work of breathing. Pulse oximetry and transcutaneous oxygen monitoring are extraordinarily useful techniques of estimating and noninvasively monitoring the neonate's oxygenation, but each method has limitations. Arterial blood gas determinations of pCO₂ provide the most accurate determinations of the adequacy of alveolar ventilation, but capillary, transcutaneous, and end-tidal techniques are also useful. An approach to and examples of acid-base disorders are presented. Three hemoglobin variants relevant to the newborn are considered: fetal hemoglobin, carboxyhemoglobin, and methemoglobin. Blood gases obtained in the immediate perinatal period can help assess perinatal asphyxia, but particular attention must be paid to the sampling site, the time of life, and the possible and proven diagnoses.

Key Words: indexing terms: neonatal respiration • bronchopulmonary dysplasia • hemoglobin • carbon dioxide monitoring • oxygen monitoring • acid-base disorders • perinatal asphyxia

The following articles in journals at HighWire Press have cited this article:

				Q. Liu, C. Fehring, T. F. Lowry, and M. T. T. Wong-Riley Postnatal development of metabolic rate during normoxia and acute hypoxia in rats: implication for a sensitive period J Appl Physiol, April 1, 2009; 106(4): 1212 - 1222. [Abstract] [Full Text] [PDF]

				D Quine and B J Stenson Does the monitoring method influence stability of oxygenation in preterm infants? A randomised crossover study of saturation versus transcutaneous monitoring Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2008; 93(5): F347 - F350. [Abstract] [Full Text] [PDF]