[CraftyLPN]

Hi..
I was wanting to know how low can O2 sats get before it starts causing brain damage to an infant... and for how long would they have to be that way? Just curious...

[nicudaynurse]

It really depends on the situation. If it is a former preemie with BPD (broncopulmonary dysplasia) then O2 sats in the mid to upper 80's would be acceptable. If it is a normal healthy infant then anything below 95% would be concerning.

Now as far as brain damage it depends on how low the O2 sats go. If the sats drop into the 80's briefly then there shouldn't be a problem. If the 02 sat's are very low even for a few minutes that can cause brain damage, but that can be dependent on a lot of factors. Infant brains can be very resilent and usually can withstand a lot more that adult brains.

I hope I answered your question. It's not an easy question because there is no magic number as to when brain damage will occur. Every situation is different. Hopefully you can get a more clear answer from someone else. Did you have a specific situation that brought this question on?

[janfrn]

Some of our CV kids tolerate sats in the 60s for months while they're undergoing staged repair. They compensate by becoming polycythemic. For some defects, having sats higher than say... 80 would cause them to start shunting and perhaps lead to arrest.

[melipeds]

We generally put the O2 on any baby below 93/94... though it depends on the situation. We don't get too concerned until Sats decrease to 90%, but again, it depends on how long and what else is going on.

I have heard recently though that Sats of around 35% have been seen in adult patients in for sleep apnoea!

[catz]

our general policy is to administer o2 on for any sats below 95% in any child unless there normal sats are below that nyway. in some hospitals i worked in as a student they waited till below 90%. either way take into consideration the childs normal.....some conditions cause lower sats in which case i ensure doctors have specified how low sats are alowed to drop b4 they want o2 started.

nytime i feel it necessary to use o2 i also notify the doctors that i have doen this since technically it is a drug that must be prescribed. thus also if i think o2 is possibly goig to be required i will ask the doctors to write it up prn on a drug chart with instructions of when to give it, covering my back

[RBNURSENZ]

I have a 3 1/2 year old daughter who had severe prolonged apnoeas as a baby. Her sats were - well non-existent at times, but we intervened early after the first few episodes. The first apnoea/alte occurred at home at 8 days old and we found her grey and with low muscle tone and repsonsiveness, but breathing. She was sometimes difficult to ventilate which was slightly reassuring to me because I had found this at home with her third event. The first major event in hospital occured when the consultant was standing on the other side of the bed and he found the same. The longest event lasted for 10 minutes and she needed bagmasking this entire time. I don't know how long her sats stayed low but as the first three events occurred at home, and the first one was unwitnessed and she was difficult to ventilate at times I guess you can draw your own conclusions - remembering that when you are in this situation seconds seem like hours.
The good news is that today she IS A MORE THAN AVERAGE three year old. Either we intevened early enough or the infant is very resilient.

[vemiliob]

If I interpreted your concern correctly, and I guess I did, it results hard to believe how can a child pass through an experience like that without suffering any brain damage?

I am working in a medium-class Clinic, where one would expect to find well educated or at least, well informed people. Mothers ready to impart breast-feeding. Responsible parents, keeping vigil 24 hours a day monitoring their children security, but unfortunately reality is quite different. Not only health care ignorance, but also negligence, sometimes hazardous. We had many cases of newborns falling down from theirs mothers’ bed, because they felt asleep while holding their baby on the unprotected bedside.

Sometimes one finds a toddler with a respiratory illness, cyanotic in his/her baby-sit with both parents happy unaware sleeping as if they where in a hotel on vacations. Very often after many weeks interned both, mother and child, go home returning after few days in a worsen state because prescriptions where not followed at all.

I wonder how can a child survive such conditions. I remember a night two month ago, a college holding the toddler in her arms, running one flour downstairs to the Neonatology Unit, after finding him in apnea while his mother slept. (We suffer an epidemic of bronchiolitis on last winter). However, after four months of working in pediatrics I can witness no death. And for that my companions have a simple and irrational explanation:

“There must be an Angel caring for every child”.
In the best case, we can assume that nature might have very important reasons to assure most children survival.
Although we are unable to grasp with profoundness such reasons, we can accept the existence of an invisible guidance that sometimes shakes us to move, in situations like those that you experience with your infant.