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Noninvasive oxygen delivery and oxygen monitoring in the newborn

Authors
Richard Martin, MD
Kathleen M Deakins, MHSA RRT NPS FAARC
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

Oxygen supplementation using noninvasive measures is an important component of intensive care of the newborn. Careful monitoring is required to minimize pulmonary toxicity or the consequences of hypoxemia or hyperoxia.

Noninvasive oxygen administration and monitoring for the neonate, including the preterm infant, will be reviewed here. Oxygen administration during neonatal resuscitation in the delivery room and neonatal mechanical ventilation are discussed separately. (See "Neonatal resuscitation in the delivery room", section on 'Supplemental oxygen' and "Mechanical ventilation in neonates".)

OXYGEN USE IN THE DELIVERY ROOM

The use of supplemental oxygen and its administration and monitoring during neonatal resuscitation in the delivery room are discussed separately. (See "Neonatal resuscitation in the delivery room", section on 'Supplemental oxygen'.)

OXYGEN USE POST-DELIVERY

Following delivery, oxygen delivery devices used in the neonatal intensive care unit (NICU) and step down units include nasal cannula, nasal continuous positive airway pressure (nCPAP), nasal intermittent positive pressure ventilation (NIPPV), or endotracheal tube if the infant requires assisted ventilation. Typically, hoods and face masks are not initially used to deliver oxygen in the neonate. These devices should provide warmed and humidified gas that is delivered using a system in which the concentration can be regulated. The inspired oxygen concentration should be monitored with an oxygen analyzer, frequently or continuously if possible.

Nasal cannula — A nasal cannula provides oxygen through two soft prongs that are inserted into the patient's anterior nares (picture 1). Both low- and high-flow oxygen delivery may be delivered by nasal cannula. Oxygen flows from the cannula into the patient's nasopharynx and mixes with room air entering from the infant's mouth and nose. Consequently, the concentration of oxygen that can be delivered by these methods varies depending upon factors such as the patient's respiratory rate, tidal volume, oxygen flow rate, and extent of mouth breathing.

                          
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Literature review current through: Oct 2017. | This topic last updated: Oct 18, 2017.
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