Sojourn in excessively high oxygen saturation ranges in individual, very low-birthweight neonates

Abstract

Aim: To investigate the variability in sojourn times at high oxygen saturations (SpO2 ) in individual patients and to examine whether there are subsets of patients or treatments that are associated with differing sojourn times at SpO2 ≥93%.

Methods: Pulse oximetry data (Masimo) were studied in 71 premature babies receiving supplemental oxygen. Outcome measure was proportion of time per 12-h shift that individual babies spent in the range SpO2 ≥93%. We studied whether an inordinate proportion of time spent at SpO2 ≥93% was attributable to any subset of babies, mode of ventilation or nursing shifts, whether sojourn times were statistically independent shift-to-shift and whether an educational intervention reduced the amount of time spent at SpO2 ≥93%.

Results: The proportion of time spent by the populations overall at SpO2 ≥93% was distributed equally among babies. However, high-frequency ventilation was associated with the least amount of time at SpO2 ≥93% compared with other modes of respiratory support (p < 0.0001), while nasal cannulae were associated with the highest proportion of time at SpO2 ≥93% (p < 0.001).

Conclusion: Measures to improve compliance with targeted SpO2 ranges should be applied universally although further improvement may be achieved by specifically targeting babies receiving supplemental oxygen via nasal cannula.

Keywords: Hyperoxia; Oximetry; Oxygen saturation; Premature infant.