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Effect of different oxygen saturation levels on death or disability in extremely preterm infants
Date:5/5/2013

of either 3 percent above or below the true values. Caregivers adjusted the concentration of oxygen to achieve saturations between 88 percent and 92 percent, which produced 2 treatment groups with true target saturations of 85 percent to 89 percent (n=602) or 91 percent to 95 percent (n=599). Alarms were triggered when displayed saturations decreased to 86 percent or increased to 94 percent. The primary outcome was a composite of death, gross motor disability, cognitive or language delay, severe hearing loss, or bilateral blindness at a corrected age of 18 months. Secondary outcomes included retinopathy of prematurity and brain injury.

The researchers found that targeting lower compared with higher oxygen saturations had no significant effect on the rate of death or disability at 18 months. "Of the 578 infants with data for this outcome who were assigned to the lower target range, 298 (51.6 percent) died or survived with disability compared with 283 of the 569 infants (49.7 percent) assigned to the higher target range," the authors write. "Of the 585 infants with known vital status at 18 months in the lower saturation target group, 97 (16.6 percent) had died compared with 88 of 577 (15.3 percent) in the higher saturation target group."

Targeting lower compared with higher saturations reduced the average postmenstrual age at last use of oxygen therapy, but had no significant effect on any other outcomes, including the rate of severe retinopathy of prematurity.

"Clinicians who try to translate the disparate results of the recent oxygen saturation targeting trials into their practice may find it prudent to target saturations between 85 percent and 95 percent while strictly enforcing alarm limits of 85 percent at all times, and of 95 percent during times of oxygen therapy. Our findings do not support recommendations that targeting saturations in the upper 80 percent range should be avoided. Because it is very difficult to maintain infants in a
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Contact: Alison Fraser
FraserA1@email.chop.edu
267-426-6054
The JAMA Network Journals
Source:Eurekalert

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