Neonatal blood gas sampling methods

Blood gas sampling is part of everyday practice in the care of babies admitted to the neonatal intensive care unit, particularly for those receiving respiratory support. There is little published guidance that systematically evaluates the different methods of neonatal blood gas sampling, where each method has its individual benefits and risks. This review critically surveys the available evidence to generate a comparison between arterial and capillary blood gas sampling, focusing on their relative accuracy and complications, as well as briefly mentioning the management of such complications. This evidence-based summary and guidance should help inform best practice in the neonatal intensive care unit, and minimise the exposure of babies to unnecessary and potentially serious risk. The most accurate and non-invasive method of measuring oxygenation is oxygen saturation monitoring. Indwelling arterial catheters are a practical, reliable and accurate method of measuring acid-base parameters, provided they are inserted and maintained with the proper care. Capillary blood gas sampling is accurate, and a good substitute for radial ‘stab’ arterial puncture, avoiding many of the complications of repeated arterial puncture.