Blood gas targets

Abstract

Blood gas measurements i.e. measurement of the levels of oxygen and carbon dioxide in arterial blood, are important parameters for critical care of sick newborns. Oxygen is one of the most commonly used as well as misused drugs in the neonatal intensive care units. Rapidly changing physiology, difficulty in access to arterial sampling sites, and small blood volumes in newborns at times present unique challenges to the treating neonatologist. Studies have shown that the use of supplemental oxygen in neonatal care may result in both significant health care benefits and harms; till date uncertainty remains as to the most appropriate range to target blood oxygen levels in preterm and low birth weight infants. Unnecessary use of oxygen in newborn babies leads to oxidative stress and damage to various organ-systems, particularly lungs, brain and eyes. Preterm newborns are most vulnerable to the toxic effects of oxygen due to their limited antioxidant defenses. There are numerous causes of hypoxia in newborns but there is only one cause of hyperoxia, namely, giving too much oxygen than what is really needed (iatrogenic). It is essential that all health professionals looking after newborn babies are sensitized to the dangers posed by hyperoxia and change their clinical practice to limit oxygen exposure in this vulnerable population.