Achievement of saturation targets in preterm infants < 32 weeks' gestational age in the delivery room

作者:White Lani Nui; Thio Marta; Owen Louise S; Kamlin C Omar; Sloss Samantha; Hooper Stuart B; Davis Peter G; Dawson Jennifer A*
来源:Archives of Disease in Childhood - Fetal and Neonatal Edition, 2017, 102(5): F423-F427.
DOI:10.1136/archdischild-2015-310311

摘要

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 (SpO(2)) targets. Our aim was to measure the proportion of time infants < 32 weeks' gestation spent within and outside prescribed SpO(2) targets during the first 10 min after birth. Method Prospective observational study using data from a preductal SpO(2) sensor and oxygen analyser measuring fraction of inspired oxygen (FiO(2)) in the inspiratory limb of the respiratory circuit. Measurements of SpO(2), heart rate and FiO(2) were recorded every 2 s. We assessed compliance with the upper SpO(2) limit only when infants were receiving supplemental oxygen. SpO(2) 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.