Oxygen saturation reference ranges and factors affecting SpO2 among children living at altitude

Arch Dis Child. 2021 Dec;106(12):1160-1164. doi: 10.1136/archdischild-2020-321545. Epub 2021 May 24.

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.

Keywords: physiology; respiratory.

Publication types

  • Observational Study

MeSH terms

  • Altitude*
  • Child, Preschool
  • Female
  • Healthy Volunteers / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Oxygen / blood*
  • Oxygen Saturation*
  • Papua New Guinea
  • Reference Values*
  • Risk Factors
  • Sleep / physiology*

Substances

  • Oxygen