Low oxygen saturation target range is associated with increased incidence of intermittent hypoxemia.
OBJECTIVE
To test the hypothesis that preterm infants randomized to a low vs high O(2) saturation target range have a higher incidence of intermittent hypoxemia.


METHODS
A subcohort of 115 preterm infants with high resolution pulse oximetry enrolled in the Surfactant, Positive Pressure, and Oxygenation Randomized Trial were randomized to low (85%-89%) or high (91%-95%) O(2) saturation target ranges. Oxygen saturation was monitored until 36 weeks postmenstrual age or until the infant was breathing room air without respiratory support for ≥72 hours.


RESULTS
The low target O(2) saturation group had a higher rate of intermittent hypoxemia (≤80% for ≥10 seconds and ≤3 minutes) prior to 12 days and beyond 57 days of life (P < .05). The duration shortened (P < .0001) and the severity increased (P < .0001) with increasing postnatal age with no differences between target saturation groups. The higher rate of intermittent hypoxemia events in the low target group was associated with a time interval between events of <1 minute.


CONCLUSIONS
A low O(2) saturation target was associated with an increased rate of intermittent hypoxemia events that was dependent on postnatal age. The duration and severity of events was comparable between target groups. Further investigation is needed to assess the role of intermittent hypoxemia and their timing on neonatal morbidity.
Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA. jmd3@case.edu
Juliann M
JM
Di Fiore
Michele
M
Walsh
Lisa
L
Wrage
Wade
W
Rich
Neil
N
Finer
Waldemar A
WA
Carlo
Richard J
RJ
Martin
D000367:Age Factors; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D015233:Models, Statistical; D008991:Monitoring, Physiologic; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods; D012720:Severity of Illness Index; D016037:Single-Blind Method
D010100:Oxygen