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Monday, November 05, 2007 - How altitude affects newborns

This column appeared in the Steamboat Today on November 5, 2007

By Christine McKelvie

“It’s the altitude.” That catch-all phrase is used to rationalize or explain a wide variety of experiences in Colorado.

Slight headaches, shortness of breath, home runs at Coors Field and even lapses in memory can be realistically or jokingly blamed on the altitude.

On a serious note, elevation does affect the amount of oxygen available to newborn babies here in Steamboat Springs. The exact, measurable relationship between altitude and oxygen saturation in a baby’s bloodstream is what Yampa Valley Medical Center neonatal nurse practitioner Tracie Line wants to discover.

Line is leading a research project at YVMC, in concert with Brigham Young University and Intermountain hospitals in Utah. All participating hospitals are located at altitudes between 4,498 and 8,150 feet.

Line hopes the data may influence future hospital and at-home care standards for infants born at moderate altitudes, especially those who have underdeveloped lungs or other health challenges.

“When I first started working at YVMC seven years ago I noticed we were sending quite a few newborns home on supplemental oxygen,” Line said. “I previously worked at sea level, where home oxygen use was not as common. My question was, ‘What is normal at this altitude?’”

Seeking a definitive answer, Line delved into published studies and found a dearth of relevant information. Research either had stopped at the mile-high mark of 5,280 feet or was performed at higher altitude, 9,000 feet and above.

“I learned what is normal for babies in Tibet, the Peruvian Andes, Leadville and Summit County, but we are at a lower altitude here,” Line said.

Line did not give up. “I talked to many researchers, neonatologists and pediatricians and finally found Dr. Patricia Ravert,” Line said. Ravert, who is a nursing educator at BYU, agreed to lead the scientific study.

“We cannot run a research study by ourselves at our little hospital,” Line explained. “But we can participate, and I am inviting hospitals in other Colorado mountain towns to join the study.”

Research involves testing healthy newborns. Parents are asked to sign a written consent form that allows YVMC Family Birth Place staff to take an oxygen-saturation reading two or three times during the newborn’s hospital stay.

“The process we use is not invasive, it does not hurt the baby, and it is anonymous,” Line explained. “We do not collect any names or medical record numbers, just the oxygen data. So far, parents have been very willing, and we appreciate that.”

Since early October, when the study began, 35 parents have consented to the testing and Line has already sent in her first batch of data collection forms.

“We need to have a total of at least 500 babies in the study from the participating hospitals,” Line said. “If we reach this number by the end of May, we can expect the study results sometime next fall.”

If the study does establish a baseline oxygen saturation level for healthy newborns, this information could help all babies who are born at altitude. Nurses and physicians will have a better way to differentiate between “well” babies and those who require special care in their first few hours, days or weeks of life.

“This baseline number will not be the only parameter we look at, but it will be an important one,” Line said. “It will help us provide appropriate care to all babies. If the norm turns out to be a number that is lower than the one we currently use, we could even reduce the number of diagnostic tests and treatment that we provide.”

Line will work with Ravert to get the study published in a neonatal or pediatric professional journal. That has been Line’s goal all along.

“The reason we pushed for this scientific research is that we want it to benefit the worldwide scientific and medical community, not just our little corner of Northwest Colorado,” she said. “This could have an impact on all babies born in the Rocky Mountain West and at similar altitudes around the world.”

Christine McKelvie is public relations director at Yampa Valley Medical Center.

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