Wackernagel D, et al. - Researchers examined if in newborn infants, monitoring peripheral oxygen saturation (SpO₂) could accurately guide oxygen titration. They retrospectively matched 27,237 SpO₂ readings with arterial oxygen saturation (SaO₂) and PaO₂ results from blood gas analyses conducted in infants with arterial catheters in place. Overestimation of SaO₂ readings by 2.9±5.8% was made using SpO₂. When pulse oximetry readings were within the defined oxygen saturation target range, 7,809 (20.9%) SaO₂ values were below and 2,830 (7.6%) surpassed the target range. They observed a three-fold increased risk of hypoxemia in infants treated with supplemental oxygen vs infants breathing room air. Fair to good sensitivity and specificity were observed for detecting upper and lower target range limits. Pulse oximetry readings did not meet the performance specifications for titrating oxygen in neonatal patients when arterial blood gas analyses were considered as reference.