Sojourn in excessively high oxygen saturation ranges in individual, very low-birthweight neonates

Area of Science:

• Neonatal care
• Respiratory support
• Clinical outcomes

Background:

• Premature infants often require supplemental oxygen, leading to potential challenges in maintaining target oxygen saturation levels.
• Variability in sojourn times at high oxygen saturation (SpO2) in premature infants receiving supplemental oxygen is not fully understood.
• Identifying factors influencing sojourn times is crucial for optimizing respiratory support and patient outcomes.

Purpose of the Study:

• To investigate individual patient variability in sojourn times at high oxygen saturation (SpO2).
• To determine if specific patient subsets or treatments are associated with differing sojourn times at SpO2 ≥93%.
• To evaluate the impact of an educational intervention on time spent at SpO2 ≥93%.

Main Methods:

• Analysis of pulse oximetry data from 71 premature infants receiving supplemental oxygen.
• Outcome measure: proportion of time per 12-hour shift spent at SpO2 ≥93%.
• Investigated associations with patient subsets, ventilation modes, nursing shifts, and an educational intervention.

Main Results:

• Overall time at SpO2 ≥93% was equally distributed among infants.
• High-frequency ventilation was associated with the least time at SpO2 ≥93% (p < 0.0001).
• Nasal cannulae were associated with the highest proportion of time at SpO2 ≥93% (p < 0.001).

Conclusions:

• Universal measures to improve compliance with targeted SpO2 ranges are recommended.
• Further improvements may be achieved by specifically targeting infants receiving supplemental oxygen via nasal cannula.
• Understanding sojourn time variability is key for refining respiratory support strategies in neonates.