What is the role of pulse oximetry in the workup of persistent pulmonary hypertension of the newborn (PPHN)?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Answer

Answer

Continuous pulse oximetry screening is valuable in the ongoing treatment of the newborn with persistent pulmonary hypertension (PPHN), allowing the caregiver to assess the patient's oxygen saturation over time and as a guide to the adequacy of oxygen delivery at the tissue level.

Oximeter probes can be placed on preductal (right hand) and postductal (feet) sites to assess for right-to-left shunting at the level of the foramen ovale and ductus arteriosus. A difference greater than 10% between preductal and postductal oxygen saturations correlates to right-to-left ductal shunting. Sites on the left hand should be avoided, because it may be preductal or postductal. Significant right-to-left shunting at the level of the foramen ovale may result in lower-than-expected preductal oxygen saturations (right hand), although a significant differential should still be evident when compared to postductal oxygen saturations.


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