Optimum oxygen therapy in preterm babies

Tin, Win; Gupta, Samir

doi:10.1136/adc.2005.092726

Cited by 119 publications

(76 citation statements)

References 36 publications

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“…Higher SpO 2 targets may induce stable sleep patterns and better long-term growth and development (32), but at the cost of retinopathy of prematurity, bronchopulmonary dysplasia, and brain injury (33,34). Alternately, the use of "restrictive" oxygen therapy has been found to produce a negative effect on the survival, cognitive functions, adaptive skills and behavior (35).…”

Section: Discussionmentioning

confidence: 99%

Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

et al. 2013

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Background:The study tested the hypothesis that hyperoxemia and hypoxemia differentially alter cerebral blood flow velocity (CBFV) in a gestational age-dependent manner. Methods: Cases comprised 98 neonates with mild respiratory distress, receiving oxygen for >24 h in first 48 h of life. Ninety-eight age-and-weight-matched healthy neonates served as controls. Infants with perinatal asphyxia, shock, sepsis, malformations, acidosis/alkalosis, and hypo/hypercarbia were excluded. Resistance index (RI), pulsatility index (PI), peak systolic flow velocity (PSV), and vascular diameter were measured in internal carotid, vertebral, and middle cerebral arteries by transcranial doppler ultrasonography between 24 and 48 h of life with immediate postdoppler arterial blood gas analysis. For subgroup analysis, neonates were divided by gestational age and PaO 2 . results: An overall decrease in RI/PI and increase in PSV and vasodilation was observed in cases. Hyperoxemia (PaO 2 >90 mm Hg) was more common in premature neonates. Neonates <32 wk showed an increase in CBFV (decreased RI/PI and increased PSV/diameter) in association with hyperoxemia. An opposite response was observed in neonates ≥32 wk, where CBFV increased in response to hypoxemia (PaO 2 <50 mm Hg) and decreased in hyperoxemia. Increased CBFV showed high predictive accuracy for immediate mortality and intracranial hemorrhage. conclusion: Depending on gestational maturity, hyperoxemia or hypoxemia produce differential effects in CBFV.

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Section: Discussionmentioning

confidence: 99%

Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

et al. 2013

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“…However, too little or too much oxygen may be associated with severe neonatal morbidities. 1,[6][7][8] Pulse oximetry has become the standard, noninvasive continuous method to estimate arterial oxygen saturation in neonates and to guide oxygen therapy. 9,10 Good compliance with alarm limits for pulse oximetry is essential to keep infants in the desired range of oxygen saturation target values, and thus to avoid hypo-or hyperoxemia.…”

Section: Discussionmentioning

confidence: 99%

“…1 Extremely preterm infants are especially susceptible to oxygen toxicity and oxidative stress. 2,3 Strict adherence to the desired range of oxygen saturation target values in these infants is required to reduce the risk of excessive exposure to oxygen.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ compliance with alarm limits for pulse oximetry: qualitative study

et al. 2009

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Objective: Monthly audits for the multicenter Canadian Oxygen Trial have shown that our neonatal team has consistently maintained study participants within the intended pulse oximetry alarm limits between 68 and 79% of the time during the first 3 days of life while infants were receiving supplemental oxygen. This good performance prompted us to explore our nurses' perceptions of what makes them compliant with alarm limits for pulse oximetry in preterm infants.Study Design: The local neonatal research nurse interviewed all 41 staff nurses in the neonatal intensive care unit at the University Children's Hospital in Tuebingen, Germany, for this qualitative study.Result: Nurses identified education (22/41), prompt response to alarms (22/41), a favorable patient-to-staff ratio (18/41), root cause analysis at the bedside (15/41), and the high priority given to control of oxygen therapy in the department (14/41) as the five most important determinants of their good compliance.Conclusion: These findings may be useful for other neonatal teams who struggle to improve their compliance with alarm limits for pulse oximetry.

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“…To provide oxygen therapy, registered nurses are responsible for adjusting FiO 2 based on the patient's current SpO 2 level. Although we have limited knowledge as to how much oxygen these patients actually need, or how much oxygen is safe to give, it is in the best interest of the patient to adjust the FiO 2 level in as close to real time as possible [1][2][3]5]. Lim et al [6] compared the effectiveness of oxygen therapy in preterm infants via manual FiO 2 adjustment against automatic FiO 2 adjustment.…”

Section: Introductionmentioning

confidence: 99%

Automatic Control of Fraction of Inspired Oxygen in Neonatal Oxygen Therapy using Fuzzy Logic Control

Chanyagorn

Kiratiwudhikul

2016

IEIE Transactions on Smart Processing and Computing

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Premature babies of less than 37 weeks gestation might require oxygen therapy as an integral part of treatment and respiratory support. Because of their under-developed lungs, these socalled "preemies" might contract respiratory distress syndrome (RDS). To treat RDS, neonatal oxygen therapy is administered, where controlled oxygen gas is measured as a fraction of inspired oxygen (FiO 2 ). However, exposure to high oxygen content during long treatment could cause oxygen intoxication, which might cause permanent blindness due to retinopathy of prematurity (ROP), whereas insufficient oxygen exposure could cause severe hypoxia. A doctor would use oxygen saturation (SpO 2 ) data and prescribe a dose of FiO 2 to maintain SpO 2 within a suitable range. One objective is to maintain SpO 2 within the acceptable range using FiO 2 that is as low as possible. Adjustment of FiO 2 would normally be done by nurses every 15 to 30 minutes, which might not be safe in many situations. An error in FiO 2 adjustment during a manual procedure could be as large as +/-2.5%. This paper presents a system that can determine an FiO 2 value suitable to the current SpO 2 and that automatically adjusts FiO 2 with an error clearance of +/-0.25%.

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Optimum oxygen therapy in preterm babies

Cited by 119 publications

References 36 publications

Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

Nurses’ compliance with alarm limits for pulse oximetry: qualitative study

Automatic Control of Fraction of Inspired Oxygen in Neonatal Oxygen Therapy using Fuzzy Logic Control

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