Oxygen-Saturation Targets and Outcomes in Extremely Preterm Infants

Askie, Lisa; Henderson‐Smart, David J; Irwig, Les; Simpson, Judy M.

doi:10.1056/nejmoa023080

Cited by 467 publications

(287 citation statements)

References 37 publications

Supporting

Mentioning

264

Contrasting

Unclassified

Order By: Relevance

“…11 A limited number of studies have examined the effect of maintaining SpO 2 in different ranges on retinopathy of prematurity (ROP) 15 and growth and neurodevelopment during the first year of life. 16 These studies were limited to convalescing premature infants and represent a different population from those in this report. There are a number of recent reports that suggest improved outcomes for BPD and ROP with tolerance of lower SpO 2 values.…”

Section: Discussionmentioning

confidence: 97%

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

et al. 2006

View full text Add to dashboard Cite

Objective: To determine if a change in the pulse oximeter goal range and high alarm limit for oxygen saturation (SpO 2 ) alters the distribution of SpO 2 for premature infants in oxygen.Study design: This was a prospective, observational analysis. For group 1 (February 2002 to April 2002, n ¼ 23), pulse oximeter alarms were set at 80% (low) and 96% (high), and the goal range was 90-95%. For group 2 (May 2002 to August 2003, n ¼ 49), the high alarm was lowered to 94%, and the goal range was 88 to 94%. The SpO 2 values for 24 h were downloaded from Nellcor pulse oximeters during the two periods and the percent time within, above and below the goal range was derived and compared.Results: Groups were similar except for use of post-natal steroids (group 2>1). The percent time within (57.7±9.8 vs 59.4±12.4%), above (15.4±10.6 vs 14±9.4%) and below (26.9±9.7 vs 26.6±10.2%) the goal range was similar for groups 1 and 2, respectively. However, the percent time with SpO 2 <80% increased significantly for group 2 (4.0±2.7 vs 1.9±1.4%).Conclusions: Changes in pulse oximeter policy and alarms in labile, sick premature infants need evaluation for their effects on the distribution of SpO 2 values before routine use.

show abstract

Section: Discussionmentioning

confidence: 97%

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Two studies have found no difference in mortality or neurodevelopmental outcomes in infants randomized to higher versus lower target oxygen saturation levels. 6,17 It is also possible that we had exposure misclassification (infants in the lower oxygen group not actually staying within their target ranges) as a result of partial lack of adherence to the new oxygen saturation policy, since we did not formally assess compliance with the policy. This misclassification would likely be a differential type, affecting the lower O2 group more than the higher O2 group, since the more stringent target oxygen saturation guidelines implemented for the lower O2 group represented a change in practice.…”

Section: Discussionmentioning

confidence: 99%

Incidence of severe retinopathy of prematurity before and after a modest reduction in target oxygen saturation levels

Wallace¹,

Veness-Meehan²,

Miller³

2007

Journal of American Association for Pediatric Ophthalmology and

View full text Add to dashboard Cite

show abstract

“…1 Infants born prematurely also have reduced antioxidant defenses and are sensitive to oxidant injury that can be exacerbated by therapeutic oxygen. [2][3][4][5] Although improved clinical treatments have reduced the incidence of airway injury, inflammation, and fibrosis typically seen in the pre-surfactant era, infants dying from BPD today have simplified alveoli that are less vascularized. 6 Analogous to the pathology seen in these infants, exposure of newborn rodents to Ն85% oxygen for 10 to 14 days causes alveolar simplification and abnormal vascular development.…”

mentioning

confidence: 99%

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Yee

White

Awad

et al. 2011

The American Journal of Pathology

108

View full text Add to dashboard Cite

Bronchopulmonary dysplasia is a chronic lung disease observed in premature infants requiring oxygen supplementation and ventilation. Although the use of exogenous surfactant and protective ventilation strategies has improved survival, the long-term pulmonary consequences of neonatal hyperoxia are unknown. Here, we investigate whether neonatal hyperoxia alters pulmonary function in aging mice. By 67 weeks of age, mice exposed to 100% oxygen between postnatal days 1 to 4 showed significantly a shortened life span (56.6% survival, n ‫؍‬ 53) compared to siblings exposed to room air as neonates (100% survival, n ‫؍‬ 47). Survivors had increased lung compliance and decreased elastance. There was also right ventricular hypertrophy and pathological evidence for pulmonary hypertension, defined by reduction of the distal microvasculature and the presence of numerous dilated arterioles expressing von Willebrand factor and ␣-smooth muscle actin. Consistent with recent literature implicating bone morphogenetic protein (BMP) signaling in pulmonary vascular disease, BMP receptors and downstream phospho-Smad1/ 5/8 were reduced in lungs of aging mice exposed to neonatal oxygen. BMP signaling alterations were not observed in 8-week-old mice. These data suggest that loss of BMP signaling in aged mice exposed to neonatal oxygen is associated with a shortened life span, pulmonary vascular disease, and associated cardiac failure. People exposed to hyperoxia as neonates may be at increased risk for pulmonary hypertension.

show abstract

Oxygen-Saturation Targets and Outcomes in Extremely Preterm Infants

Abstract: Targeting a higher oxygen-saturation range in extremely preterm infants who were dependent on supplemental oxygen conferred no significant benefit with respect to growth and development and resulted in an increased burden on health services.

Cited by 467 publications

References 37 publications

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Incidence of severe retinopathy of prematurity before and after a modest reduction in target oxygen saturation levels

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Contact Info

Product

Resources

About