Desaturation

Risk Factors

There are several risk factors that increase the risk of a baby struggling with desaturation. These are:

• Being born too early. The earlier a baby is born, the higher the risk
• Infants of diabetic mothers
• Down syndrome
• Exposure to certain kinds of medications in the womb

Diagnosis

The healthcare team will start by speaking to the infant’s parents and examining the baby. They may also use these instruments and tests to gather more information:

• Pulse oximetry – a small, nonpainful device which is placed onto a baby’s hands or feet to measure oxygen levels in their blood.
• Transcutaneous monitor – a small electrode which is heated and taped onto a baby’s skin to continuously monitor oxygen and carbon dioxide levels. The device will be moved every few hours to avoid accidental burns.
• Arterial blood gases – this is considered the ‘gold standard’ for assessing oxygen levels but is used less often because it requires a blood draw.
• Cardiorespiratory monitors – these electrodes are attached to a baby’s skin to monitor breathing rate, heart rate, and heart rhythm.

The following tests may be requested to look for the underlying cause of oxygen desaturation:

• ECG – a heart tracing which watches a baby’s heartbeat
• Blood tests
• Imaging such as a chest x-ray, CT scan, or MRI
• Echocardiogram – this is a test where the doctor watches the blood flow through a baby’s heart

Complications

Baby’s who suffer desaturation have an increased risk of complications due to the loss of oxygen and additional complications or long-term conditions may arise.  Some of these complications are:

• Retinopathy of prematurity – this is when the blood vessels around a baby’s eyes do not grow properly. It can cause problems with the baby’s vision. Using oxygen therapy to treat desaturations can sometimes make this worse.
• Learning disorders
• Pulmonary hypertension – high blood pressure in the heart and lungs
• In severe cases, death

Treatment

Most children diagnosed suffer from desaturation as an infant will improve as they age with the proper treatment. The common treatments are:

• Oxygen – necessary to help the baby breath with struggling
• Mechanical ventilation – a machine gently pumps oxygen into a baby’s lungs
• Caffeine – can protect the lungs from damage from oxygen therapy
• Prescription medications – these medications can be breathed in to strengthen the lungs

Most premature babies will have fewer desaturations as they come closer to their original due date. This gives their bodies time to complete the development of their respiratory centre and muscles for breathing.

Prevention

The best way to prevent oxygen desaturations is to have a healthy pregnancy. Expecting mothers should take prenatal vitamins per the directions of their obstetrician or midwife, attend all recommended prenatal visits, eat a healthful diet, and drink plenty of fluids. Expecting mothers should stop smoking, avoid alcohol, and stop any illicit drug use while pregnant.