OXIMETER READINGS FOR CHILDREN AND WHAT COULD CAUSE THEM TO BE LOW.

Oxygen saturation is a clinical measurement that determines what percentage of a patient’s red blood cells are saturated with oxygen after passing through the lungs. It is a result that reflects not only how well a patient’s lungs are working but also how effectively oxygen is being delivered to all parts of the body. In a healthy child breathing room air, the oxygen saturation levels will be between 96 and 98 percent. Falling levels of oxygen saturation are concerning to physicians and may require intervention.

SIGNIFICANCE

Oxygen saturation is an accurate measurement that reflects multiple aspects of a child’s cardiovascular health. Monitoring the percent of red blood cells saturated with oxygen tells a physician how well a child is breathing, how efficiently the oxygen is being distributed to the body and how well oxygen is unloaded from red blood cells at its destination. A disruption in any of these processes will decrease the child’s oxygen saturation and can necessitate therapeutic intervention.

FUNCTION

Oxygen saturation sensing in a healthy child breathing room air will reveal a saturation rate between 96 and 98 percent. This is the normal range for a healthy adult as well. A disruption in oxygen metabolism can cause saturation levels to drop below 95 percent, at which point a physician might order intervention. Saturation levels that fall below 90 percent often require oxygen therapy, in which higher than normal amounts of oxygen are fed directly into the child’s nose.

TYPES

Typically, oxygen saturation is measured with a pulse oximeter. This is a painless clip that can be attached to the child on either a finger, toe or even ear lobe and detects the extent of oxygen saturation in the blood in that region, however in more sensitive cases physicians may draw arterial blood from the child to directly measure oxygen levels.

BENEFITS

Since measurement is simple, painless and cost-effective, it is a very efficient method for catching a change in oxygen delivery before severe consequences occur. Home-use pulse oximeters are widely available for home monitoring of oxygen saturation levels both at rest and during exercise.

WARNING

In a hospital, falling oxygen levels are detected immediately and corrected in extreme situations with oxygen therapy. If you are monitoring your at-risk child at home, however, and you detect a drop in oxygen levels, consult your physician immediately. Efficient correction of low oxygen levels can help prevent long-term consequences and allow your child to lead a healthier life.

RESPIRATORY PROBLEMS

Most children with low oxygen saturation have a respiratory disorder. Any disease that interfere with oxygen flow through the lungs can cause a low oxygen saturation, including conditions such as pneumonia, croup or chronic diseases such as cystic fibrosis or bronchopulmonary disease, which makes the lungs stiff.

Newborns who breathe irregularly or who have apneic periods where they stop breathing may also have low oxygen saturation.

Children with asthma may have normal oxygen saturation, except when they have an asthma attack. Giving supplemental oxygen normally raises the oxygen saturation in children with respiratory disease, although severe asthma or lung damage, which narrows and constricts the tubes in the lungs, can make it difficult for oxygen to reach the lungs.

POOR TISSUE PERFUSION

If your child has poor tissue perfusion, the pulse oximeter will have difficulty reading the oxygen saturation accurately. Poor tissue perfusion means that not enough blood is flowing to an area. Extreme cold, decreased blood volume due to blood loss or dehydration, very low blood pressure, heart failure or diseases that disrupt blood flow to the arms and legs can all cause low oxygenation saturation due to poor perfusion.

An irregular heartbeat can make it difficult for the pulse oximeter to record an accurate reading. If the child has a blood pressure cuff on the same arm as a pulse oximeter, the cuff interferes with blood flow when it pumps up, causing low readings.

MOVEMENT

If you’re child is moving around or crying, SpO2 may be artificially low because the machine can’t lock onto the signal long enough to read it. During a seizure, SpO2 will also fall, both because of decreased oxygenation and because of the child’s movement. Vibrations in a moving vehicle, plane or helicopter, during a medical transport, for instance, will also interfere with readings.

OTHER PROBLEMS

If your child has sickle cell anaemia, the irregular and abnormal shapes of the red blood cells can cause SpO2 to be either too high or too low. A number of mechanical problems can also interfere with the pulse oximeter, causing low readings. Very bright light shining on the pulse oximeter can skew the readings, as can very dark nail polish on a fingernail. Dark skin colour does not cause low readings, however. Pulse oximeters do not measure carbon dioxide and can’t diagnose respiratory failure due to carbon dioxide retention, states S.J. Fearnley of the Department of Anaesthetics at Torbay Hospital in the United Kingdom.

OXYGEN SATURATION IN INFANTS

The health of an infant is assessed in various ways, including observation and measurement of important blood components. Measurement of oxygen saturation provides information about a child’s respiratory, heart and circulatory health. It is part of an assessment of vital signs for an infant, particularly if the newborn is premature or experiences breathing difficulty.

OXYGEN SATURATION

Oxygen saturation reflects the quantity of haemoglobin in the blood that is saturated with oxygen. Haemoglobin is the component of red blood cells that binds oxygen and transports it to body tissues. Oxygen saturation is commonly measured by pulse oximetry. This instrument uses an infrared light source to detect oxygen saturation without collecting a blood sample. A pulse oximeter is typically wrapped around an infant’s foot or hand to obtain a measurement.

FULL-TERM INFANTS

A healthy, full-term baby should have an oxygen saturation of 95 to 100 percent. Some health care facilities may have slightly different parameters. Full-term newborns who require supplemental oxygen after birth may have slightly lower oxygen saturation levels.

PREMATURE INFANTS

Babies born prematurely have lower oxygen saturation levels initially because their lungs are not fully developed. Normal oxygen saturation for a preterm infant is roughly 84 to 90 percent. A newborn who is unable to maintain a minimum oxygen saturation level — whether full-term or premature — may be placed on supplemental oxygen. The health care team monitors an infant’s oxygen saturation level and adjusts the flow rate and concentration of supplemental oxygen to maintain a normal level.

HYPOXEMIA

Infants with an oxygen saturation level below a normal level have hypoxemia — or oxygen deficiency. For an infant not wearing a pulse oximeter, hypoxemia may not be readily apparent. For example, a bluish discolouration around the lips called cyanosis is a physical sign of low blood oxygen. However, this sign often does not develop until the oxygen saturation drops to 75 percent or less in a full-term infant.

RETINOPATHY OF PREMATURITY

Maintaining a lower oxygen saturation than typically considered normal may be acceptable or preferable in some situations. Because lung tissue is one of the last to fully develop in a fetus, premature babies frequently require supplemental oxygen. Treatment with high levels of oxygen may lead to retinopathy of prematurity, an eye disorder that can lead to blindness. Adjusting the supplemental oxygen to maintain oxygen saturation at a lower level decreases the occurrence of ROP.

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OXYGEN SATURATION IN EXERCISE

Your red blood cells carry oxygenated blood throughout the entire body. In apparently healthy adults, the red blood cells that pass through the lungs are between 95 and 100 percent saturated with oxygen. Each red blood cell is able to carry four molecules of oxygen. Oxygen saturation is the measure of how much oxygen each red blood cell is carrying. It is also expressed as Sp02.

INVASIVE TEST

Oxygen saturation can be measured in one of two ways. A blood gas analysis is one direct method to measure oxygen levels. During this invasive test a small amount of blood is drawn out of an artery. This is different from most lab draws, because they are usually drawn from a vein. The radial artery on the wrist is the most common site for an arterial blood gas draw.

NONINVASIVE TEST

The second, noninvasive method is through the use of a pulse oximeter. An oximeter is a clip, normally placed on the finger, that emits a light on one side. When placed on the finger, the light is measured as it comes through the other side of the finger. It works on the principle that oxygen saturated cells absorb light differently than those that are not. The oximeter gives out a digital reading of your estimated blood oxygen level.

ACTIVITY RESPONSE

Normal oxygen levels of 95 to 100 percent allow the proper pressure within the body to allow the oxygen to be absorbed into the muscles. If your levels at rest are in the normal range, that also allows for a small supply of oxygen to be stored in the muscles. Once you begin to exercise, your rate and depth of respiration increases to help meet the increase in oxygen demands. A normal response in regards to oxygen saturation is a possible drop of only 2 to 3 percent. Ideally, that level will stay above 92 percent during exercise to keep the proper pressure of oxygen in the blood.

HYPOXEMIA

Low blood oxygen levels, or hypoxemia, are those below 90 percent. Several medical conditions can cause hypoxemia. These include COPD, emphysema, anaemia, pulmonary embolism, sleep apnea, shock or pneumonia, to name a few.

SYMPTOMS OF HYPOXEMIA

More than likely you don’t have a pulse oximeter at home to measure your oxygen levels at any given moment. The symptoms that should lead you to seek medical attention include: shortness of breath while at rest, shortness of breath with exercise or even mild activity, or waking in the middle of the night gasping for air. OXYGEN SUPPLEMENTATION

If your oxygen levels do regularly fall below the normal values, your physician may prescribe supplemental oxygen. The purpose of supplemental oxygen is so you can inhale 100 percent pure oxygen, compared to room air which is only 21 percent oxygen. Some must wear oxygen all the time, others only while sleeping or exercising. PREVENTION

There are many things you can do to lower your risk of developing diseases that lead to low oxygen perfusion levels. Quitting smoking, avoiding secondhand smoke and performing regular physical exercise will all help lower your chance of developing hypoxemia.

CAN VITAMINS INCREASE YOUR OXYGEN?

The cells in your body need oxygen to carry out metabolism and produce enough energy to live and support your activities. Red blood cells are responsible for picking up oxygen from your lungs, transporting it in your bloodstream and delivering it to cells that need it. You need iron and a variety of vitamins for maintaining high numbers of healthy red blood cells to keep oxygen levels in your blood as high as necessary. Nutrition may prevent anaemia, or unhealthy red blood cells, but hypoxemia, or low blood oxygen, can be a serious medical condition that requires a doctor’s attention, according to the Mayo Clinic.

VITAMIN C

Iron is the mineral in red blood cells that binds to oxygen, and vitamin C increases your body’s ability to absorb iron in its nonheme form, according to the Linus Pauling Institute Micronutrient Information Centre. Nonheme iron is the form that you get from plant-based sources of iron, such as potatoes, prunes, beans, lentils and nuts. Some of the best sources of vitamin C are citrus fruits, such as oranges, grapefruits and their juices, tomatoes, onions, strawberries, bell peppers and potatoes. Vitamin C does not affect the absorption of heme iron from animal-based sources.

VITAMINS FOR HEME

Your blood oxygen levels could be low if you are not getting enough pantothenic acid, or vitamin B-5, and vitamin B-6. These vitamins are essential for synthesising heme, which is the protein part of the haemoglobin molecule that carries iron and oxygen in your blood, according to the Linus Pauling Institute Micronutrient Information Centre. Both of these vitamins are in a wide range of foods, such as fish, chicken, vegetables, nuts and lentils.

VITAMIN B-12

A deficiency of vitamin B-12 leads to megaloblastic anaemia, with low blood oxygen levels and symptoms of fatigue and shortness of breath, according to the National Institutes of Health. Deficiency is rare among individuals who eat a varied diet, but strict vegetarians, or vegans, may be at risk for vitamin B-12 deficiency. The only natural sources of vitamin B-12 are animal-based foods, such as fish, yogurt, milk, chicken, beef and shrimp, but it is also in many fortified cereals.

VITAMIN A

Vitamin A deficiency makes iron deficiency more severe, so if you have low blood oxygen levels, be sure to take enough vitamin A, according to the Linus Pauling Institute. Vitamin A is in meats, cod liver oil, carrots, sweet potatoes, spinach, mangoes, melon and pumpkin, as well as fortified milk. Vitamin A from fruits and vegetables does not lead to symptoms of toxicity, but it is possible to get toxic doses of vitamin A from meat or dietary supplements. Consult your doctor to reduce your risk of symptoms such as headaches, fatigue or muscle aches.