A comparison of manual versus automated saturation of peripheral oxygenation in the neonatal intensive care unit

Background: It is vital to maintain the saturation of peripheral oxygenation (SpO(2)) in a targeted range in extremely premature infants to improve survival without significant morbidities. Objectives: To compare manual versus automated monitor documentations of daily upper and lower values of SpO(2) in premature infants. Methods: In a prospective observational study, the highest and lowest daily SpO(2) manually recorded values from electronic medical records were compared with automatically recorded values from bedside cardiorespiratory monitors. Results: Eighteen infants were monitored for 605 patient days, with a mean birth weight of 859 +/- 183 g, and gestational age of 26.0 +/- 1.3 wks. Within the lowest SpO(2) values, manually recorded values were consistently higher than the simultaneous automatically recorded monitor values. The highest SpO(2) point differences in documentation was seen in patients with SpO(2) range <= 70% (16 +/- 13 points), followed by 71-80% (10 +/- 7 points) and 81-90% (7 +/- 4 points); p < 0.01. Conclusions: The difference between manually and automatically recorded SpO(2) is large in lower SpO(2) ranges and small in higher SpO(2) ranges. Automated oxygen administering systems should be considered to reduce potential errors.