Oxygen Saturation Targeting and Bronchopulmonary Dysplasia

We studied 12 infants with a clinical and radiologic diagnosis of bronchopulmonary dysplasia who were oxygen dependent and older than 30 days. Simultaneous readings of hemoglobin oxygen saturation (Sao2) determined by two pulse oximeters (Nellcor 100, BTI Biox III) and transcutaneous (tc) Po2 (Sensor Medics, Transend) were correlated with Sao2 (Radiometer, OSM 2 Hemoximeter) and Pao2 (Corning 178) measured on blood from an indwelling arterial catheter. For each infant, the fractional inspiratory oxygen (Fio2) was adjusted to obtain three to five sets of data in the range of 70% to 95% Sao2. Fifty-three data points were generated and pooled for analysis. The slope of the regression line generated for the Nellcor 100 was .86; for the BTI Biox III, it was .91; and for the Sensor Medics Transend, it was .55, resulting in average errors of +2.5%, +1.0%, and –29%, respectively, when comparing corresponding transcutaneous and arterial values. When Sao2 was equal to or less than 95%, no infants were hyperoxic. These data confirm reports by others that tcPO2 values do not accurately represent Pao2 values in older infants with bronchopulmonary dysplasia. Pulse oximeters do not require user calibration, and their sensor is unheated so they will not cause skin burns. We conclude that pulse oximetry offers major advantages over tcPo2 measurements in the management of infants with bronchopulmonary dysplasia.

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Oxygen Saturation in Premature Neonates with Bronchopulmonary Dysplasia in a Hammock

Neonatology ◽

10.1159/000244143 ◽

1995 ◽

Vol 67 (1) ◽

pp. 54-58 ◽

Cited By ~ 5

Author(s):

Vincenzo Zanardo ◽

Daniele Trevisanuto ◽

Carlo Dani ◽

Michele Bottos ◽

Alberto Guglielmi ◽

...

Keyword(s):

Oxygen Saturation ◽

Bronchopulmonary Dysplasia ◽

Premature Neonates

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Effect of oxygen saturation targets on the incidence of bronchopulmonary dysplasia and duration of respiratory supports in extremely preterm infants

Paediatrics & Child Health ◽

10.1093/pch/pxz058 ◽

2019 ◽

Vol 25 (3) ◽

pp. 173-179

Author(s):

Youstina Hanna ◽

Corinne Laliberté ◽

Nadya Ben Fadel ◽

Brigitte Lemyre ◽

Bernard Thébaud ◽

...

Keyword(s):

Mechanical Ventilation ◽

Oxygen Saturation ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Primary Outcome ◽

Statistical Significance ◽

Extremely Preterm ◽

Lower Oxygen ◽

Secondary Outcomes ◽

The Difference

Abstract Background Recent clinical practice changes in neonatal care resulted in higher, narrower oxygen saturation target ranges for preterm infants. The effect of targeting higher or lower oxygen saturations on respiratory outcomes of preterm infants and duration of hospitalization has not been extensively reviewed in the context of current care, but could have significant implications. Methods A multicentre retrospective cohort of 145 preterm infants was conducted; 105 had lower oxygen saturation targets (88 to 92%), 40 had higher targets (90 to 95%). The primary outcome was bronchopulmonary dysplasia (BPD). Secondary outcomes included duration of invasive/noninvasive respiratory support, oxygen therapy, and hospitalization. The primary outcome was compared using Fisher’s exact test. Secondary outcomes were evaluated with survival analysis and Wilcoxon rank sum test. Results The difference in incidence of BPD in the lower (N=56, 53.3%) and higher saturation groups (N=14, 35.0%) was not statistically significant (relative risk [RR]=0.66 [0.41, 1.04], P=0.06). The difference in duration of mechanical ventilation in the lower (median 7.8 days, interquartile range [IQR] 3.7 to 15.9) and higher saturation groups (median 4.5, IQR 1.9 to 12.3) approached statistical significance (P=0.05). There were no statistically significant differences in the durations of other respiratory supports or hospital stay between the two groups. Conclusions The results of this study approached statistical significance and suggest that higher, narrower oxygen saturation targets may result in a clinically important reduction in BPD incidence and duration of mechanical ventilation. These results require validation in a larger sample to refine optimal targets.

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APNEA IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA DEPENDING ON ITS SEVERITY

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2013-19-4-348-355 ◽

2013 ◽

Vol 19 (4) ◽

pp. 348-355

Author(s):

N. A. Petrova ◽

I. V. Dobrodeeva ◽

N. P. Shabalov ◽

.. O. Ivanov ◽

V. V. Petrenko ◽

...

Keyword(s):

Oxygen Saturation ◽

Bronchopulmonary Dysplasia ◽

Premature Infants ◽

Gestational Age ◽

Respiratory Control ◽

Third Age ◽

Prolonged Apnea ◽

Design And Methods

Objective. To evaluate bronchopulmonary dysplasia (BPD) impact on apnea incidence and characteristics in infants.Design and methods. We performed cardiorespiratory monitoring in 25 premature infants with BPD and 25 non-BPD preterms comparable in gestational age (26–30 weeks) at ages of less than 29 days, 29–50 days and > 50 days. Results. Infants with moderate to severe BPD tended to have higher apnea incidence when older than 50 days, and more obstructive episodes, compared to infants with mild BPD and without BPD. Infants with mild BPD had similar apnea type ratio as non-BPD infants. In the second and third age intervals, infants with moderate to severe BPD demonstrated similar prolonged apnea incidence but had rather more apnea accompanied by oxygen saturation (SрO2) falls ≤ 80 %, compared to infants with mild BPD and without BPD. During the irst month infants with mild BPD demonstrated shorter apnea episodes, less prolonged apnea and more apnea with SрO2≤80 % falls compared to non-BPD infants. During the second age interval these characteristics did not differ between the groups. Conclusion. Infants with moderate to severe BPD had longer apnea persistence, more signiicant SрO2falls due to apnea. Respiratory control characteristics seem to be comparable in mild BPD and non-BPD infants from the second month of age.

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