Temporal quantification of oxygen saturation ranges: an effort to reduce hyperoxia in the neonatal intensive care unit.
OBJECTIVE
To reduce exposure to hyperoxia and its associated morbidities in preterm neonates.


METHODS
A multidisciplinary group was established to evaluate oxygen exposure in our neonatal intensive care unit. Infants were assigned target saturation ranges and signal extraction technology implemented to temporally quantify achievement of these ranges. The outcomes bronchopulmonary dysplasia/death, retinopathy of prematurity (ROP)/death, severe ROP and ROP requiring surgery were compared in a pre- versus post-intervention evaluation using multivariate analyses.


RESULTS
A total of 304 very low birth weight pre-initiative infants were compared with 396 post-initiative infants. Multivariate analyses revealed decreased odds of severe ROP (adjusted odds ratio (OR): 0.41; 95% confidence interval (CI): 0.24-0.72) and ROP requiring surgery (adjusted OR 0.31; 95% CI: 0.17-0.59) post-initiative. No differences in death were observed.


CONCLUSIONS
Significant reductions in severe ROP and ROP requiring surgery were observed after staff education and implementation of new technology to quantify success in achieving targeted saturations and reinforce principles and practices.
Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
M J
MJ
Bizzarro
Yale Center for Analytical Sciences, New Haven, CT, USA.
F Y
FY
Li
Yale Center for Analytical Sciences, New Haven, CT, USA.
K
K
Katz
Yale Center for Analytical Sciences, New Haven, CT, USA.
V
V
Shabanova
Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
R A
RA
Ehrenkranz
Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
V
V
Bhandari
D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D005260:Female; D006801:Humans; D018496:Hyperoxia / Q000097:blood / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D012178:Retinopathy of Prematurity / Q000517:prevention & control
D010100:Oxygen