Graded oxygen saturation targets and retinopathy of prematurity in extremely preterm infants

Abstract

Background:We compared the incidence of severe retinopathy of prematurity (ROP) and need for laser treatment before and after implementing graded pulse oximeter oxygen saturation (SpO 2 ) targets in extremely preterm infants. Mortality and other secondary outcomes were compared. Methods: Before 2002, we used 90-94% as the SpO 2 target in infants 24 0/7 -27 6/7 wk gestation and birth weight <1,000 g until 35 6/7 wk postmenstrual age (PMA). We implemented graded SpO 2 targets based on vaso-obliterative and vaso-proliferative phases of ROP in 2002. Group 1 (1995 (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) after implementation of graded SpO 2 targets based on PMA (83-89% until 32 6/7 wk, 90-94% until 35 6/7 wk and >94% at ≥ 36 wk PMA). results: There were 267 patients in Group 1 and 220 in Group 2. There was no significant difference in birth weight or gestational age. Severe ROP (adjusted OR: 0.18, 95% CI: 0.11, 0.30; P < 0.001) and laser surgery rates (adjusted OR: 0.31, 95% CI: 0.18, 0.52; P < 0.001) decreased significantly in Group 2. There was no difference in mortality (adjusted OR: 0.74, 95% CI: 0.37, 1.49; P = 0.40). conclusion: In this retrospective cohort study, implementation of graded SpO 2 targets decreased severe ROP and need for laser therapy, without increasing mortality.before, and Group 2

Hypoxemic and hyperoxemic likelihood in pulse oximetry ranges: NICU observational study

“…This is consistent with our findings. Others have suggested that a somewhat lower target could be a better balance of outcome risks 10 14 27 28. Our data would support the latter as well, if the clinical goal was to reduce the likelihood of hyperoxemia and accept a marginal increase in the likelihood of hypoxemia.…”

Oxygen saturation targeting by pulse oximetry in the extremely low gestational age neonate: a quixotic quest

“…[30] It may also make physiologic sense to titrate SpO 2 target ranges based on individual patient characteristics, such as gestational age, postmenstrual age, and transfusion status; some have embraced this concept of a “moving target” for SpO 2 . [31]…”

Non-invasive high-frequency oscillatory ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: Study protocol for a multi-center prospective randomized controlled trial

“…FiO 2 will be adjusted to target oxygen saturation (SpO 2 ) from 89% to 93% in preterm infants <30 weeks GA and from 90 to 94% in infants ≥30 weeks GA by pulse oximeter [ 8 ].…”