Improving compliance with pulse oximetry alarm limits for very preterm infants?

To determine if participation in a randomised controlled trial of different oxygen saturation targets improved compliance with oximeter alarm limit guidelines.

Eligible infants were born after the commencement of the BOOST II trial. Data on alarm limits were collected on all infants <32 weeks' gestational age or birth weight <1500 g, who were born at The Royal Women's Hospital, Melbourne between February and June 2007, and receiving supplemental oxygen at the time of the audit. The proportions of infants in oxygen with correct alarm limits (upper 94%; lower 85% or 86%) were compared, between those in the BOOST II trial and those who were not, and with an earlier audit.

Of 100 infants surveyed, 56 had received oxygen (mean gestational age at birth 26.7 weeks, mean birth weight 913 g). Compliance with lower limits was good in both periods, irrespective of post-menstrual age or participation in the trial. Compliance with upper limits improved after trial commencement, but only for infants enrolled in the trial and only whilst they were <36 weeks' post-menstrual age.

Starting a clinical trial of oxygen targeting was associated with improved compliance with upper alarm limits for participants receiving supplemental oxygen, but only whilst they were <36 weeks; with little effect outside the trial.