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Published on: August 19, 2020
Optimal oxygen saturations in preterm infants: a moving target
1NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia. lisa.askie@ctc.usyd.edu.au
Current evidence suggests targeting lower oxygen saturation levels in preterm infants may increase early mortality. Until optimal ranges are defined, maintaining oxygen saturation above 90% is advisable for premature babies.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Neonatal Intensive Care
Background:
- Optimal oxygen saturation targets for preterm infants remain uncertain.
- Existing evidence is limited, with few randomized trials.
- Higher oxygen saturation may increase risks of retinopathy and pulmonary issues.
Purpose of the Study:
- To address the ongoing uncertainty regarding optimal oxygen saturation targets in preterm infants.
- To review current evidence and identify gaps in knowledge.
- To inform clinical practice and future research directions.
Main Methods:
- Systematic review of existing evidence.
- Analysis of interim results from four independent randomized trials.
- Establishment of a collaborative group investigating five randomized trials.
Main Results:
- Higher oxygen saturation levels are associated with increased risk of severe retinopathy of prematurity and pulmonary morbidities.
- Interim results from four trials indicate increased early mortality when targeting lower oxygen saturation ranges.
- Data on long-term neurodevelopmental outcomes and effects of various target ranges are lacking.
Conclusions:
- Defining and maintaining optimal oxygen saturation levels in preterm infants is a clinical challenge.
- Ongoing collaborative research efforts are expected to provide further guidance.
- Current evidence suggests avoiding oxygen saturation targets below 90%.
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