Oximeters used for continuous monitoring experience periods with no signal. This SpO2 drop-out is widely acknowledged and its causes generally understood. This is a prospectively designed analysis of an existing database with the aim of characterizing drop-outs as experienced in the neonatal ICU. The data reflects 116 days of monitoring in seven tertiary care neonatal ICUs in 6 countries. From the evaluation of 1,396 drop-outs we found that typically the time was minimal with missing SpO2 data, and the episodes were short (median 2.79 minutes per day IQR 0.17–76, median 22 seconds IQR: 15–37, respectively). During about half of the days there were no prolonged dropouts (1 minute or longer), even so half of the total time spent with no SpO2 data were in prolonged episodes (median length 110 seconds IQR 85–150). The predominate factor associated with excessive drop-out time was the number of prolonged episodes rather than their duration. We concluded that the impact of drop-outs during manual control of inspired oxygen primarily impact alarm fatigue, but that during automatic FiO2 control they could have an important impact. The relative effectiveness of the fall-back strategies of these automatic control systems ought to be evaluated.

Czech Technical University Prague Kladno Czech Republic

Department of Biomedical Technology Faculty of Biomedical Engineering

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