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. 2000;2001(2):CD001076.
doi: 10.1002/14651858.CD001076.

Early versus late discontinuation of oxygen in preterm or low birth weight infants

L M Askie  1 , D J Henderson-Smart
Affiliations

Early versus late discontinuation of oxygen in preterm or low birth weight infants

L M Askie et al. Cochrane Database Syst Rev. 2000.

Update in

Abstract

Background: This section is under preparation and will be included in the next issue.

Objectives: In preterm or low birth weight infants, does early versus late weaning from supplementary oxygen influence mortality, retinopathy of prematurity, lung function, growth or development?

Search strategy: The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. An additional literature search of the MEDLINE, EMBASE, and CINAHL databases was conducted in order to locate any trials in addition to those provided by the Cochrane Controlled Trials Register (CENTRAL/CCTR).

Selection criteria: All trials utilising random or quasi-random patient allocation, in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants, were eligible for inclusion.

Data collection and analysis: The methodological quality of the one eligible trial was assessed independently by each author for the degree of selection, performance, attrition and detection bias. Data regarding clinical outcomes including mortality, retinopathy of prematurity, and long term growth and development were extracted and reviewed independently by each author. Results were compared and differences resolved as required. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.

Main results: In the single eligible trial of 99 infants with birthweights less than 1650g, there were no significant differences in neonatal death rates or retrolental fibroplasia (any grade or severe) for all infants, or among infants with birth weights of less than 1000g. No other outcome measures specified a priori as clinically meaningful were reported in enough detail or with satisfactory follow-up rates to include in the analysis (early death; chronic lung disease; and long term growth, development, lung or visual function).

Reviewer's conclusions: The results of this systematic review do not provide strong evidence for either the benefits or harms of early oxygen weaning in preterm/LBW infants. Future research should be directed toward addressing the question of what are the most appropriate target levels of oxygenation, in both the early and late neonatal periods, rather than whether oxygen should be weaned early or late.

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Conflict of interest statement

The authors of this review are currently conducting a randomized, controlled trial of the effect of higher versus standard oxygen saturation targeting on long term growth and development of preterm infants.

References

References to studies included in this review

Engle 1955 {published data only}
    1. Engle MA, Baker DH, Baras I, Freemond A, Laupus WE, Norton EW. Oxygen administration and retrolental fibroplasia. American Journal of Diseases of Children 1955;89:399‐413. - PubMed
    1. Engle MA, Levine SZ. Response of small premature infants to restriction of supplementary oxygen. American Journal of Diseases of Children 1955;89:316‐24. - PubMed

References to studies excluded from this review

Simoes 1997 {published data only}
    1. Simoes EAF, Rosenberg AA, King SJ, Groothius JR. Room air challenge: prediction for successful weaning of oxygen‐dependent infants. Journal of Perinatology 1997;17:125‐9. - PubMed

Additional references

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References to other published versions of this review

Askie 2001
    1. AskieLM, Henderson‐Smart DJ. Early versus late discontinuation of oxygen in preterm or low birth weight infants (Cochrane Review). Cochrane Database of Systematic Reviews 1998, Issue 4. [DOI: 10.1002/14651858.CD001076] - DOI - PubMed

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