How deep is too deep and how long is too long? The effect of haemoglobin concentration on buffering capacity during desaturation in preterm infants

We write in response to the manuscript by Franz AR, et al.1 Oxygen kinetics describes a coordinated process that maintains oxygen sufficiency by matching delivery to metabolic demand. In a dynamic system, small adjustments are constantly made, even during periods of stability. However, when consumption rises, delivery falls, or both occur simultaneously, compensatory mechanisms may become exhausted. At this critical threshold, oxygen consumption becomes dependent on delivery, leading to anaerobic metabolism and the risk of hypoxic injury.2