title: Improving blood gas control in mechanically ventilated, premature infants through monitoring and evaluation of clinical practice.
abstract: Mechanical ventilation causing hypocapnia or hyperoxia carries a risk for the pre-term infant. The aim was to improve blood gas control in our unit. A guideline was written, and all personnel were motivated concerning blood gas control. Case records of all mechanically ventilated premature infants were examined during two 3-month periods, before and after intervention. The hours spent with hypocapnia (pCO2 < 4 kPa) or hyperoxia (PO2 > 12 kPa) were recorded. Case records of 31 infants were examined for a total of 1358 h of mechanical ventilation, 641 h before and 717 h after the intervention. The percentage time of hypocapnia before intervention (7.0%) was reduced significantly (P = 0.044) to less than half (2.9%) after intervention. Hyperoxia was reduced from 14.5% to 8.7% (P = 0.072). Blood gas control of mechanically ventilated premature infants could be improved with little effort, but hyperoxia is too frequent.
authors.affiliation: Department of Neonatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. jacobsteinmetz@hotmail.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Steinmetz
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
mesh_terms: D001784:Blood Gas Analysis / Q000592:standards*; D004501:Education, Medical / Q000379:methods; D004506:Education, Nursing / Q000379:methods; D006801:Humans; D018496:Hyperoxia / Q000517:prevention & control; D016857:Hypocapnia / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008991:Monitoring, Physiologic / Q000592:standards*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards; D012121:Respiration, Artificial / Q000592:standards*