Lani Nui White1, Marta Thio2,3,4, Louise S Owen2,3,4, C Omar Kamlin2,3,4, Samantha Sloss1, Stuart B Hooper5, Peter G Davis2,3,4, Jennifer A Dawson2,3,4. 1. The Royal Melbourne Hospital Academic Centre, University of Melbourne, Melbourne, Victoria, Australia. 2. Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia. 3. Murdoch Children's Research Institute, Parkville, Victoria, Australia. 4. The University of Melbourne, Melbourne, Victoria, Australia. 5. Hudson Institute of Medical Research, Clayton, Australia.
Abstract
BACKGROUND: To reduce the risks of hypoxia and hyperoxia in preterm infants in the delivery room; national and international guidelines recommend titrating supplemental oxygen delivery to achieve specific oxygen saturation (SpO2) targets. Our aim was to measure the proportion of time infants <32 weeks' gestation spent within and outside prescribed SpO2 targets during the first 10 min after birth. METHOD: Prospective observational study using data from a preductal SpO2 sensor and oxygen analyser measuring fraction of inspired oxygen (FiO2) in the inspiratory limb of the respiratory circuit. Measurements of SpO2, heart rate and FiO2 were recorded every 2 s. We assessed compliance with the upper SpO2 limit only when infants were receiving supplemental oxygen. SpO2 measurements were recorded as being below, within or above the target at each time point. We measured the number of times infants were continuously below or above the target range for more than 30 s. RESULTS: Twenty-seven infants; mean (SD) 28 (3.4) weeks and 962 (370) g were studied. Infants were below, within and above the prescribed targets for 28%, 35% and 37% of the first 10 min after birth, respectively. CONCLUSIONS: Preterm infants spent almost two-thirds of the first 10 min after birth with oxygen saturations outside prescribed target ranges. New titration strategies are required to reduce the risks of hypoxia and hyperoxia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: To reduce the risks of hypoxia and hyperoxia in preterm infants in the delivery room; national and international guidelines recommend titrating supplemental oxygen delivery to achieve specific oxygen saturation (SpO2) targets. Our aim was to measure the proportion of time infants <32 weeks' gestation spent within and outside prescribed SpO2 targets during the first 10 min after birth. METHOD: Prospective observational study using data from a preductal SpO2 sensor and oxygen analyser measuring fraction of inspired oxygen (FiO2) in the inspiratory limb of the respiratory circuit. Measurements of SpO2, heart rate and FiO2 were recorded every 2 s. We assessed compliance with the upper SpO2 limit only when infants were receiving supplemental oxygen. SpO2 measurements were recorded as being below, within or above the target at each time point. We measured the number of times infants were continuously below or above the target range for more than 30 s. RESULTS: Twenty-seven infants; mean (SD) 28 (3.4) weeks and 962 (370) g were studied. Infants were below, within and above the prescribed targets for 28%, 35% and 37% of the first 10 min after birth, respectively. CONCLUSIONS: Preterm infants spent almost two-thirds of the first 10 min after birth with oxygen saturations outside prescribed target ranges. New titration strategies are required to reduce the risks of hypoxia and hyperoxia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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