Target Oxygen Saturation Among Preterm Neonates on Supplemental Oxygen Therapy: A Quality Improvement Study

Abstract

Objective

To avoid excessive oxygen exposure and achieve target oxygen saturation (SpO2) within intended range of 88%–95% among preterm neonates on oxygen therapy.

Methods

20 preterm neonates receiving supplemental oxygen in the first week of life were enrolled. The percentage of time per epoch (a consecutive time interval of 10 hours/day) spent by them within the target SpO2 range was measured in phase 1 followed by implementation of a unit policy on oxygen administration and targeting in phase 2. In phase 3, oxygen saturation histograms constructed from pulse-oximeter data were used as daily feedback to nurses and compliance with oxygen-targeting was measured again.

Results

48 epochs in phase 1 and 69 in phase 3 were analyzed. The mean (SD) percent time spent within target SpO2 range increased from 65.9% (21.4) to 76.5% (12.6) (P=0.001).

Conclusion

Effective implementation of oxygen targeting policy and feedback using oxygen saturation histograms may improve compliance with oxygen targeting.

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References

  1. 1.

    Stenson BJ. Oxygen saturation targets for extremely preterm infants after the NeOProM Trials. Neonatol. 2016;109:352–8.

    Article  Google Scholar 

  2. 2.

    Vijayakumar E, Ward GJ, Bullock CE, Patterson ML. Pulse oximetry in infants of <1500 gm birth weight on supplemental oxygen: A national survey. J Perinatol. 1997;17:341–5.

    PubMed  CAS  Google Scholar 

  3. 3.

    Hagadorn JI, Furey AM, Nghiem TH, Schmid CH, Phelps DL, Pillers DA, et al. Achieved versus intended pulse oximeter saturation in infants born less than 28 weeks’ gestation: the AVIOx study. Pediatrics. 2006;118:1574–82.

    Article  PubMed  Google Scholar 

  4. 4.

    Ford SP, Leick-Rude MK, Meinert KA, Anderson B, Sheehan MB, Haney BM, et al. Overcoming barriers to oxygen saturation targeting. Pediatrics. 2006;118:S177–86.

    Article  PubMed  Google Scholar 

  5. 5.

    Chow LC, Wright KW, Sola A, CSMC Oxygen Administration Study Group. Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants? Pediatrics. 2003;111:339–45.

    Article  PubMed  Google Scholar 

  6. 6.

    Coe K, Butler M, Reavis N, Klinepeter ME, Purkey C, Oliver T, et al. Special Premie Oxygen Targeting (SPOT): A program to decrease the incidence of blindness in infants with retinopathy of prematurity. J Nurs Care Qual. 2006;21:230–5.

    Article  PubMed  Google Scholar 

  7. 7.

    Ellsbury DL, Ursprung R. Comprehensive oxygen management for the prevention of retinopathy of prematurity: The pediatrix experience. Clin Perinatol. 2010;37:203–15.

    Article  PubMed  Google Scholar 

  8. 8.

    Claure N, Gerhardt T, Everett R, Musante G, Herrera C, Bancalari E. Closed-loop controlled inspired oxygen concentration for mechanically ventilated very low birth weight infants with frequent episodes of hypoxemia. Pediatrics. 2001;107:1120–4.

    Article  PubMed  CAS  Google Scholar 

  9. 9.

    Laptook AR, Salhab W, Allen J, Saha S, Walsh M. Pulse oximetry in very low birth weight infants: Can oxygen saturation be maintained in the desired range? J Perinatol. 2006;26:337–41.

    Article  PubMed  CAS  Google Scholar 

  10. 10.

    Arawiran J, Curry J, Welde L, Alpan G. Sojourn in excessively high oxygen saturation ranges in individual, very low-birthweight neonates. Acta Paediatr. 2015;104:e51–6.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Ashok K. Deorari.

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Sivanandan, S., Sethi, T., Lodha, R. et al. Target Oxygen Saturation Among Preterm Neonates on Supplemental Oxygen Therapy: A Quality Improvement Study. Indian Pediatr 55, 793–796 (2018). https://doi.org/10.1007/s13312-018-1391-4

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Keywords

  • Monitoring
  • Oxygen management
  • Pulse oximetry