Buyers Guide

Pulse Oximeters for Detecting Hypoxaemia and Monitoring Oxygen

Despite progress in reducing infant and child deaths over the past twenty years, an estimated 6 million children and young adolescents die each year, most of which are from preventable causes such as birth complications, pneumonia, diarrhea, neonatal sepsis, and malaria.  The highest risk occurs in the first month of life, with newborn mortality representing the majority of infant and child deaths globally. (1) 

Every year, approximately 1.5 million babies and children die from causes related to Respiratory Distress Syndrome (RDS), pneumonia, asphyxia, sepsis, and other infections. (2)  For preterm babies, RDS is especially dangerous due to insufficient lung development, in which there is a deficiency of lung surfactant that is needed to keep the lungs from collapsing (alveolar collapse). These respiratory conditions can result in hypoxemia, which is low levels of oxygen in the body. Despite its importance in acute severe illnesses, hypoxemia is often not well recognized or managed in settings where resources are limited. 

It is therefore important for health workers to know the clinical signs of hypoxemia, and have access to supplemental oxygen and respiratory support devices as essential life-saving treatment options. (3) VIA’s Buyers Guides for Respiratory and Oxygen Support will cover specific respiratory devices as well as basic supplemental oxygen, although consultation with clinical experts and understanding of the resources at the facilities will be important considerations. 

Related Buyers Guides

Bubble CPAP (bCPAP)

Bubble Continuous Positive Airway Pressure (bCPAP) therapy is a common mode of treatment more suitable for RDS in premature babies and other respiratory illness in children.

Oxygen Therapy (concentrators, patient interface)

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Mechanical Ventilators

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Types of Solutions for Respiratory and Oxygen Support

 

Breathing support and oxygen therapy are cornerstones of care for newborns who may be having difficulty making the transition from fetal to neonatal life, and for treating infants who are experiencing other respiratory infections or acute illness. Newborn respiratory care, either through non-invasive respiratory support or mechanical ventilation, will depend on health care workers with variable backgrounds, health care facilities with different levels of resources, and the need to treat a variety of respiratory problems and populations both non-invasive and more invasive devices and strategies. 

 

Oxygen is essential for treatment of hypoxemia; and with adequate tools and regular training, respiratory and oxygen support can be life-saving. Such tools include:

    • Sources of oxygen: including concentrators, cylinders, or pipelines, which can offer the most consistent and cost-effective supply of oxygen in health facilities.
    • Respiratory Support Devices  such as bCPAPs, resuscitators, suction devices, and ventilators
    • Oxygen Accessories for Delivery, and Regulation methods: airway interfaces, tubing, flowmeters and flowsplitters, humidifiers, and blenders, 
    • Oxygen monitoring with Pulse oximetry: pulse oximeters are critical for diagnosing hypoxemia and monitoring oxygen saturation 

     *denotes Buyers Guides and products available through VIA Global Health

Ensuring that sick newborns and premature babies are sufficiently healthy and ready to go home requires a holistic and integrated system of technologies that includes everything from supplemental oxygen (either produced locally at a health facility or delivered and stored) and devices for flow regulation and conditioning of oxygen which provide breathing support, to consumables for oxygen delivery to the patient. In addition, pulse oximetry is used to detect hypoxaemia and monitor oxygen saturation during oxygen therapy for respiratory difficulty. Finally, devices for continuity of power and power quality, devices for monitoring oxygen concentration, and spare parts for equipment maintenance, along with the capacity to maintain them, are also essential components of effective oxygen systems.

Depending on the resources at the healthcare facility and patient requirements, the providers will need to decide on a breathing support, or ventilation strategy, that is gentle enough and effective enough to help the baby breathe, and this will depend on the baby’s size, health status, and if the baby is doing some of his or her own breathing already.   Outlined below are technologies that provide breathing and oxygen support for newborns, and VIA Buyers Guides for products* as a resource for purchasing decision-making.

Read more in our Buyers Guides for

  • bCPAPS
  • Resuscitators (suction devices, bag-valve-mask)
  • Mechanical Ventilators
  • Pulse Oximeters
  • Oxygen Concentrators
  • Oxygen Accessories

VIA Global Health is committed to supporting health systems access affordable and appropriate medical technology to strengthen newborn care, and improve the quality of maternal and newborn care from the time of pregnancy through the postnatal period.   Products included in our Buyers Guides are commercially available and that VIA is able to sell.  There are other commercially available devices on the market.   

Acknowledgements: PATH Resources, NEST 360, Laerdal Global Health 

References

(1) https://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2018/en/

(2) IHME https://ourworldindata.org/child-mortality#what-are-children-dying-from

(3) World Health Organization. (2016). Oxygen therapy for children. Geneva, Switzerland: Retrieved from https://apps.who.int/ iris/bitstream/handle/10665/204584/9789241549554_eng. pdf?sequence=1.

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