When do low blood oxygen levels become harmful for children with COPD?

Question

We have a 22 month old child born 16 weeks premature. He has been in the hospital on a ventilator for about the past 40 days with several illnesses (i.e: pneumonia, flu-A, 'H'-flu, e.t.c.) His sat levels range from low 60's to low 90's; sometimes staying level for hours (usually high 70's to low/mid 80's), sometimes fluctuating 10, even 15% within minutes with the former being more common.
When we were in the N.I.C.U. the neonatologists stressed the importance of keeping the sats in the mid to high 90's, This was due to the still developing heart, brain, and lungs. With these organs much further along in development, is it still necessary to worry about keeping the O2 sats as high?
We are trying to balance the damage done to the lungs by the ventilator with what may be done to the brain by staying at lower sat levels. The lung damage is physically easier to determine than the possible brain damage. Is anyone aware of any clinical studies? (sat level X time = damage)? THNK U!

Answer 1

All studies indicate the need for continued oxygen therepy and follow up observations by experts in the neonatal field of pulmonology. Here is a partial article from the web. (Don't let outside opinions guide your decisions! Check with the Doctors) But stay informed and ask them their thoughts on the topics you search. Here ya go--Methods. This was a descriptive, nested, cohort study of nasal cannula oxygen prescription among 187 infants with birth weights of <1250 g. All infants were studied at a postmenstrual age of 36 weeks, with a timed oxygen reduction challenge to establish their ability to be weaned to room air. The results of this challenge were compared with the fraction of inspired oxygen (FIO2) delivered, calculated as effective FIO2. Infants who maintained oxygen saturation values of 90% during oxygen weaning and during a 30-minute period in room air were defined as passing the challenge.

Results. Fifty-two infants (27.8%) were receiving oxygen concentrations and flow rates through nasal cannulae that delivered an effective FIO2 of <0.23, of whom 16 were receiving oxygen concentrations and flow rates that delivered an effective FIO2 of 0.21. In addition, 22 infants (11.8%) were prescribed room air through nasal cannulae intentionally. Seventy-two percent of those prescribed an effective FIO2 of <0.23 passed the room air challenge.

Conclusions. Prescription of oxygen with combinations of flow rates and oxygen concentrations that delivered a low effective FIO2 was common. We speculate that some of this, including the inadvertent prescription of an effective FIO2 equivalent to that of room air, is related to lack of knowledge of the effective FIO2. Routine calculation of effective FIO2 values may prompt earlier trials of room air and thus reduce unnecessary days of oxygen therapy.

Answer 2

Yes everyone needs to keep their 02 sats in the mid to high 90's. This is how much oxygenation we need in the blood for the body to function properly. In our nursing home most of our patient with oxygen orders have order to at least keep the 02 sats at 92 % or above.

Answer 3

First, you child doesn't have COPD. COPD is obstructive lung diseases in adults. in addition of the diseases you stated are obstructive lung diseases.

O2 sats are important at any age. All the cells of the body need oxygen. Good O2 sats are 90% and above.

Good luck.