Original ArticleOxygen Saturation Targeting in Preterm Infants Receiving Continuous Positive Airway Pressure
Section snippets
Methods
We conducted a prospective observational study in preterm infants receiving CPAP and supplemental oxygen at 2 Australian tertiary neonatal centers, Royal Hobart Hospital (RHH), Hobart and Royal Women's Hospital, Melbourne (RWH). Both units use CPAP for initial and step-down respiratory support in preterm infants. CPAP is generated with either a bubble CPAP system (Fisher and Paykel HealthCare, East Tamaki, New Zealand) or a mechanical ventilator (Babylog 8000 plus, Dräger Medical Systems Inc,
Results
A total of 45 infants were studied, 32 at RHH, and 13 at RWH. Median gestation was 30 weeks (IQR 27-32 weeks), birth weight 1.3 (0.93-1.8) kg, and age at first recording 1 (0-8) days (Table I; available at www.jpeds.com). At the onset of each recording, infants were receiving support with a median CPAP level of 7 (6-8) cmH2O and FiO2 0.25 (0.22-0.29).
In all, 4113 hours of data were recorded, of which 79 hours (1.2%) were excluded for missing SpO2 signal. Of the 4034 hours of usable data, 2971
Discussion
Despite controversies regarding what the optimal SpO2 target range for preterm infants should be, the importance of SpO2 is indisputable, particularly when supplemental oxygen is being delivered. We evaluated SpO2 targeting in preterm infants receiving CPAP and found that when receiving oxygen, infants spent only 31% of the time in the target SpO2 range. Prolonged episodes of serious hypoxia, and of hyperoxia in oxygen, were relatively frequent, with hypoxic events more likely when nursing
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Supported by the Royal Hobart Hospital Research Foundation, Hobart, Australia (starter grant 12-019). J.D. received an Australian National Health and Medical Research Council Post Doctoral Fellowship. The authors declare no conflicts of interest.