title: Lower early postnatal oxygen saturation target and risk of ductus arteriosus closure failure.
abstract: BACKGROUND
  Early postnatal hyperoxia is a major risk factor for retinopathy of prematurity (ROP) in extremely premature infants. To reduce the occurrence of ROP, we adopted a lower early postnatal oxygen saturation (SpO2) target range (85-92%) from April 2011. Lower SpO2target range, however, may lead to hypoxemia and an increase in the risk of ductus arteriosus (DA) closure failure. The aim of this study was therefore to determine whether a lower SpO2target range, during the early postnatal stage, increases the risk of DA closure failure.
  
  
  METHODS
  Infants born at <28 weeks' gestation were enrolled in this study. Oxygen saturation target range during the first postnatal 72 h was 84-100% in study period 1 and 85-92% in period 2.
  
  
  RESULTS
  Eighty-two infants were included in period 1, and 61 were included in period 2. The lower oxygen saturation target range increased the occurrence of hypoxemia during the first postnatal 72 h. Prevalence of DA closure failure in period 2 (21%) was significantly higher than that in period 1 (1%). On multivariate logistic regression analysis, the lower oxygen saturation target range was an independent risk factor for DA closure failure.
  
  
  CONCLUSIONS
  Lower early postnatal oxygen saturation target range increases the risk of DA closure failure.
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Inomata
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Taniguchi
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yonemoto
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawase
authors.affiliation: Department of Neonatology, Perinatal Center, Kumamoto City Hospital, Kumamoto City, Kumamoto, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kondo
mesh_terms: D006348:Cardiac Surgical Procedures; D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D000860:Hypoxia / Q000097:blood* / Q000150:complications; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000601:surgery; D019102:Infant, Very Low Birth Weight; D008297:Male; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D010100:Oxygen
keywords: ductus arteriosus ligation; extremely premature infant; hypoxemia; oxygen saturation; patent ductus arteriosus