title: Gestational age-adapted oxygen saturation targeting and outcome of extremely low gestational age neonates (ELGANs).
abstract: OBJECTIVE
  Optimal oxygen saturation (SpO2) targets for extremely low gestational age neonates (ELGANs, gestational age [GA] <28 weeks) are unknown. Conflicting results from five recently published multicentre trials, which randomised ELGANs to high (91 to 95%) or low (85 to 89%) SpO2 targets from birth up to a corrected GA of 36 weeks, prompted us to examine our experience with two different SpO2 policies.
  
  
  METHODS
  We retrospectively compared outcomes of two cohorts of ELGANs which were exposed to two different SpO2 target policies adapted to the infants' corrected GA. Between 1 January 2000 and 30 June 2007, SpO2 targets were 85 to 95% at <30 weeks and 88 to 97% at ≥30 weeks (high SpO2 target cohort, n = 157). Between 1 July 2007 and 31 December 2011, SpO2 targets were lowered to 80 to 90% at <30 weeks, 85 to 95% between 30 and 34 weeks and finally 88 to 97% at ≥34 weeks (low SpO2 target cohort, n = 84).
  
  
  RESULTS
  There were no statistically significant differences between the high and low SpO2 target cohorts in mortality rates (15.9 vs 17.9%, risk ratio [RR] 0.89; 95% confidence interval [CI] 0.50-1.60), incidences of severe retinopathy of prematurity (2.3 vs 0%, RR 3.68; 95% CI 0.19-70.3), or moderate/severe bronchopulmonary dysplasia (14.4 vs 21.1%, RR 0.68; 95% CI 0.37-1.26).
  
  
  CONCLUSIONS
  Adapting SpO2 targets to the advancing corrected GA seems safe and is associated with low incidences of short-term complications. Mortality rates did not vary with the two different SpO2 target policies utilised and were comparable to those reported from recently published randomised controlled SpO2 target trials.
authors.affiliation: Neonatal and Pediatric Intensive Care Unit, Children's Hospital of Lucerne, Switzerland.
authors.forename: Anja
authors.initials: A
authors.lastname: Hergenhan
authors.affiliation: Division of Pediatric Critical Care, University of California, San Francisco, California, USA.
authors.forename: Martina
authors.initials: M
authors.lastname: Steurer
authors.affiliation: Neonatal and Pediatric Intensive Care Unit, Children's Hospital of Lucerne, Switzerland.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Berger
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000378:metabolism*; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood; D010313:Partial Pressure; D016032:Randomized Controlled Trials as Topic; D012015:Reference Standards; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D010100:Oxygen