LAUSR

In this issue of Pediatric Pulmonology, Terrill et al present an objective graphical method for the quantification of SpO2 changes in nocturnal oximetry recordings that they apply to study healthy infants and preterm neonates. As the authors state in their paper, the clinical significance of mild intermittent hypoxemia events is unknown. They propose that the currently used numerical oximetry parameters (eg, median SpO2, oxygen desaturation index,% recording time, and frequency of SpO2drops below specific thresholds) do not adequately describe the complex, physiologically relevant information contained within oximetry tracings. Lack of standardized interpretation of continuous oximetry and shortage of physiologically meaningful indices may have concealed potential long-term consequences of hypoxemia. The fact that no detrimental effects of hypoxemia are evident when common clinical and laboratory measures are employed does not necessarily mean that they are non-existent. For instance, decreased cerebral oxygen delivery in infants with congenital heart disease is associated with reduced cortical grey matter volume and gyrification, when high resolution magnetic resonance imaging is employed. Moreover, the potential effects of hypoxemia accompanying acute respiratory disorders on neurocognitive outcomes have not been explored.