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Oxygen saturation reference ranges and factors affecting SpO2 among children living at altitude
  1. Vanessa Binene1,
  2. Doreen Panauwe1,
  3. Rhondi Kauna1,
  4. John D Vince2,
  5. Trevor Duke3,4
  1. 1Paediatrics, Wabag General Hospital, Wabag, Papua New Guinea
  2. 2Clinical Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
  3. 3Intensive Care Unit and University of Melbourne Department of Paediatrics, Royal Childrens Hospital Paediatric Intensive Care Unit, Parkville, Victoria, Australia
  4. 4Child Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
  1. Correspondence to Professor Trevor Duke, Intensive Care Unit and University of Melbourne Department of Paediatrics, Royal Childrens Hospital Paediatric Intensive Care Unit, Parkville, VIC 3052, Australia; trevor.duke{at}rch.org.au

Abstract

Aims To determine reference values for oxygen saturation (SpO2) among healthy children younger than 5 years living at moderately high altitude in Papua New Guinea and to determine other factors that influence oxygen saturation levels.

Methods 266 well children living at 1810–2630 m above sea level were examined during immunisation clinic visits, and SpO2 was measured by pulse oximetry. Potential risk factors for hypoxaemia were recorded and analysed by multivariable analysis.

Results The median SpO2 was 95% (IQR 93%–97%), with a normal range of 89%–99% (2.5–97.5 centiles). On multivariable analysis, younger children, children of parents who smoked, those asleep and babies carried in bilums, a traditional carry bag made of wool or string, had significantly lower SpO2.

Conclusion The reference range for healthy children living in the highlands of Papua New Guinea was established. Besides altitude, other factors are associated with lower SpO2. Some higher-risk infants (preterm, very low birth weight, recurrent acute lower respiratory infection or chronic respiratory problem) may be more prone to hypoxaemia if they have additive risk factors: if parents smoke or they are allowed to sleep a bilum, as their baseline oxygen saturation may be significantly lower, or their respiratory drive or respiratory function is impaired. These findings need further research to determine the clinical importance.

  • respiratory
  • physiology

Data availability statement

Data are available upon request

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Data availability statement

Data are available upon request

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Footnotes

  • Contributors VB and TD designed the study, performed the data analysis and wrote the first drafts of the manuscript. VB recruited subjects and gathered the data. DP and RK assisted in the data collection. DP, TD and VJ supervised the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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