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Acta Paediatr. 2019 Sep;108(9):1584-1589. doi: 10.1111/apa.14808. Epub 2019 Apr 25.

Adherence to oxygen saturation targets increased in preterm infants when a higher target range and tighter alarm limits were introduced.

Author information

1
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
2
Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.
3
Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
4
Department of Neuroscience, Ophthalmology, Uppsala University, Uppsala, Sweden.
5
Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
6
Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.

Abstract

AIM:

European consensus guidelines published in May 2013 recommended a target peripheral capillary oxygen saturation (SpO2 ) range of 90-95% for preterm infants. These were incorporated into guidelines at the Karolinska University Hospital, Sweden, in November 2013. This study compared clinical practice before and after those local guidelines.

METHODS:

We included infants who were born between 23 + 0 and 30 + 6 weeks from January 1, 2013 to December, 31 2015 and received intensive care in two Karolinska units. The lower saturation target of 88-92% and alarm limits of 85-95% used before November 2013 were compared to the new higher saturation target of 90-95% and alarm limits of 89-96%.

RESULTS:

Data from 399 infants were analysed. The mean SpO2 was 92.4% with the higher target (n = 301) and 91.1% with the lower target (n = 98). Using the higher instead of lower target meant that the SpO2 was within the prescribed target range more frequently (51% versus 30%) and the proportion of time with SpO2 >95% was increased by 9% (95% confidence interval 7-11%, p < 0.001).

CONCLUSION:

The higher saturation target and tighter alarm limits led to higher mean oxygen saturation, increased adherence to the target and increased time with hyperoxaemia.

KEYWORDS:

Oxygenation; Preterm infants; Pulse oximetry; Retinopathy of prematurity; Saturation target

PMID:
30951230
DOI:
10.1111/apa.14808

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