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Clinical Investigations: SLEEP AND BREATHING |

Reference Values for Nocturnal Home Pulse Oximetry During Sleep in Primary School Children*

Michael S. Urschitz, MD; Judith Wolff; Volker von Einem; Pilar M. Urschitz-Duprat; Martin Schlaud, MD, PhD; Christian F. Poets, MD
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*From the Departments of Pediatric Pulmonology and Neonatology (Mrs. Wolff and Mrs. Urschitz-Duprat), Biomedical Engineering (Mr. von Einem), and Epidemiology, Social Medicine and Health System Research (Dr. Schlaud), Hannover Medical School, Hannover, Germany; the Division of Neonatology (Dr. Urschitz), Department of Pediatrics, Vienna General Hospital, University of Vienna, Vienna, Austria; and Department of Neonatology (Dr. Poets), University Hospital of Tuebingen, Tuebingen, Germany.

Correspondence to: Christian F. Poets, MD, Department of Neonatology, University Hospital of Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany; e-mail: christian-f.poets@med.uni-tuebingen.de



Chest. 2003;123(1):96-101. doi:10.1378/chest.123.1.96
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Objective: To provide reference values for pulse oximeter saturation (Spo2) in primary school children, measured at home during sleep.

Methods: Recordings of Spo2 and signal quality from 100 children were randomly selected from a larger population-based sample intended to study the prevalence of sleep-disordered breathing. Recordings were analyzed for the duration of artifact-free recording time (AFRT), minimum Spo2 (SATmin) and median Spo2 (SAT50), the Spo2 below which the child spent 5% of AFRT (SAT5), and the Spo2 below which the child spent 10% of AFRT (SAT10). In addition, the time in seconds with Spo2 ≤ 90% per hour of AFRT (TI90) was calculated, as were the number of falls in Spo2 by ≥ 4% per hour of AFRT (DI4), the number of falls in Spo2 to ≤ 90% per hour of AFRT (DI90), and the number of falls in Spo2 to ≤ 92% per hour of AFRT (DI92).

Results: Ten recordings had to be excluded because of insufficient AFRT (< 5 h). Mean age of the remaining 90 children (54 girls) was 9.3 years (SD, 0.6). Median (range; fifth centile) values for SATmin, SAT5, SAT10, and SAT50 were 93% (76 to 97; 87.5), 97% (88 to 99; 95), 97% (89 to 99; 96), and 98% (94 to 100; 97). Median values (range; 95th centile) for Ti90, DI4, DI90, and DI92 were 0.0 s (0.0 to 5.8; 1.6), 0.8 (0.0 to 6.1; 3.9), 0.0 (0.0 to 1.2; 0.2), and 0.0 (0.0 to 2.0; 0.6).

Conclusion: Baseline Spo2 values < 97% were uncommon in these children, as were intermittent desaturations to ≤ 90%. These data may serve as a basis for the interpretation of clinical recordings of Spo2 in children referred for sleep-related breathing disorders.


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