Full Term Baby, blood ox levels low to mid 90s

[shermainehelenalyssalau]

Full term baby born 40+6 experienced respiratory distress of unknown origin that sent her to the NICU. She stabilized easily and has been on room air no canula for 2.5 days and has no signs of distress. Lung X-rays are clear, echocardiogram is clear, swallow studies clear. Baby is nursing and bottle feeding fine. However her blood ox levals are consistently 90-95 and not 95-100 as the nurse says they should be. Doctors want to send us home today (baby is now 6 days old) but we aren’t sure who to listen too? What are your experiences with blood ox levels and discharge?

Thanks for your help!

*edited to add: I also want to add that the lower stats tend to happen when she’s in deep rest, which is another thing that makes our nurses a little concerned

 

[evnoca]

@shermainehelenalyssalau Just a friendly FYI, the tag “angel babies” refers to posts about babies that have passed.

 

[shermainehelenalyssalau]

@evnoca So sorry that’s not the tag I meant to use!

 

[evnoca]

@shermainehelenalyssalau You’re not the first to do it! Totally understandable!

 

[sergeireborn]

@shermainehelenalyssalau We just want to see O2 >90% the majority of the time. Most babies will dip, we just don’t know it because they aren’t constantly on monitors. Babies can sit at 88-92% and be perfectly comfortable, for adults they really need to be >95%.

 

[shermainehelenalyssalau]

@sergeireborn Thanks for this! It seems the preferred baseline varies form physician to physician which is why we’ve been a little confused as for who to listen to. The nurses are saying they’d be asking for more time/testing at the hospital before discharge while the doctors are saying it’s perfectly safe to bring her home. We love everyone here in the NICU and trust them all equally so it’s tough?

 

[shermainehelenalyssalau]

@sergeireborn I also want to add that the lower stats tend to happen when she’s in deep rest, which is another thing that makes our nurses a little concerned.

 

[way_to_galway]

@shermainehelenalyssalau From our 113 day stay, we ranged from 14-100%depending on the situation, oxygen machine, sickness etc.

When we swapped oxygen machines (vent - cpap - cannula) it was always a rocky few days as she got used to lower form of support. Our settings in the nicu were.

89-100 - normal range
79-88 - caution
78 and below - potential issue.

We also had a bar graph that would show the past 30 minutes of alerts and some days it was busy and others it was nothing. For going home she had to experience no “events” that required intervention for 5 days. Honestly, that range sounds normal and don’t see any concerns with the information we were given during our stay. Personally, I would ask the neonatologist and ask the opinion on what the nurses are saying and get clarification. They won’t send you home if they didn’t feel she was not ready.

 

[chretien22]

@shermainehelenalyssalau Hi! We were also tern 37w and we were in the NICU for being born blue, some occasional apnea that quickly resolved, excess fluid on every chest X-ray that wouldn’t clear up, and after failing 4 air room tests, went home on 1/8 liter of oxygen, where we are now, coming up on 8w old. We’ve been home for 1 month as of yesterday.

We would not have major desats, but rather she would just slowly drift lower and lower into the upper 70s and stay there and they would fail her. And while her blood gasses were ‘ok’ they weren’t stellar, they were consistent of a baby who isn’t taking deep enough breaths to move co2 out of her body to avoid these desats.

In order to get off oxygen, we will need to stay above 90 in any and all trials. 92 for most of the time would be a ‘pass’ 95-100 is normal range for adults, we start to “feel it” below that point, but babies are nowhere near as steady, and they don’t “feel it” nearly that early. Plus, your little one is only 6 days old, she has time and growth on her side! That is likely why the doctors are not concerned.

Good luck to you. For us, coming home on oxygen and hospital grade monitors has been a blessing and a curse. A curse because of course it’s scary and cumbersome and lots of people don’t understand. A blessing because we know her sats and heart rate at all times lol we even use the heartrate to tell how deep her sleep is and determine if she’s just stirring in her sleep or waking up! I’m fearful of the day when they take the monitor from us and say she’s good to go. My husband and I liken that feeling to free-solo climbing lmao

 

[ansonthms]

@shermainehelenalyssalau Has she had an echo? Just something I'd consider discussing with them to double check everything you can if you're feeling nervous about going home with that question unanswered. I hope she goes up for you shortly!

 

[shermainehelenalyssalau]

@ansonthms Yes echo was normal

 

[ansonthms]

@shermainehelenalyssalau Wonderful that is reassuring!

 

[chretien22]

@shermainehelenalyssalau Hi! We were also tern 37w and we were in the NICU for being born blue, some occasional apnea that quickly resolved, excess fluid on every chest X-ray that wouldn’t clear up, and after failing 4 air room tests, went home on 1/8 liter of oxygen, where we are now, coming up on 8w old. We’ve been home for 1 month as of yesterday.

We would not have major desats, but rather she would just slowly drift lower and lower into the upper 70s and stay there and they would fail her. And while her blood gasses were ‘ok’ they weren’t stellar, they were consistent of a baby who isn’t taking deep enough breaths to move co2 out of her body to avoid these desats.

In order to get off oxygen, we will need to stay above 90 in any and all trials. 92 for most of the time would be a ‘pass’ 95-100 is normal range for adults, we start to “feel it” below that point, but babies are nowhere near as steady, and they don’t “feel it” nearly that early. Plus, your little one is only 6 days old, she has time and growth on her side! That is likely why the doctors are not concerned.

Good luck to you. For us, coming home on oxygen and hospital grade monitors has been a blessing and a curse. A curse because of course it’s scary and cumbersome and lots of people don’t understand. A blessing because we know her sats and heart rate at all times lol we even use the heartrate to tell how deep her sleep is and determine if she’s just stirring in her sleep or waking up! I’m fearful of the day when they take the monitor from us and say she’s good to go. My husband and I liken that feeling to free-solo climbing lmao

 

[mikesekurity]

@shermainehelenalyssalau While oxygen saturations in the lower 90s aren't typical, they also aren't dangerous or abnormal to the point that this would require you to stay in the hospital. Some babies with this will just normalize over the next few weeks, and the others may have something that needs to be investigated further but again, not in the hospital. It sounds reasonable for you to get discharged and follow this up with your pediatrician afterward.

 

[bifford]

@shermainehelenalyssalau NICU RN here! For all of our patients we have the parameters set to be above 88% on the pulse ox. Really we want to see above 90%. If she’s higher when awake and a bit lower when asleep, that’s fairly normal. We see that a LOT, especially in our patients still on oxygen. Their oxygen will be fine when they’re awake but they’ll dip when asleep. If she’s going lower while asleep but still above 90%, my personal opinion is that she is doing perfectly fine, and definitely safe to go home!

Congrats on the new baby!

 

[robinebc40]

@shermainehelenalyssalau Our daughter had a double lobectomy of her right lung the moment she was born at 36+5 due to a CCAM, on top of already being diagnosed with pulmonary hypoplasia (small lungs). We left the hospital with her at 101 days. She was on ECMO, vent, CPAP, HiFlo O2, LoFlo O2 and finally room air for a week before she was discharged. Her last week she satted in the 90-95 range when awake and would occasionally drift to 87-90 range when in deep sleep. Her doctors were not concerned about that. She has since been back to the hospital for a G-Tube surgery after being discharged for 2 months. When she was back on the pulse ox for that she was satting in the 95-100 range when awake and 90-95 range when asleep.