title: Oxygen saturation targeting by pulse oximetry in the extremely low gestational age neonate: a quixotic quest.
abstract: OBJECTIVE
  A collaboration of comparative effectiveness research trials of pulse oximeter saturation (SpO2) targeting in extremely low-gestational-age neonates have begun to report their aggregate results. We examine the results of those trials, collectively referred to as the Neonatal Oxygenation Prospective Meta-analysis or NeOProM. We also discuss the uncertainties that remain and the clinical challenges that lie ahead.
  
  
  RESULTS
  The primary outcome from NeOProM was a composite of death or disability at 18-24 months corrected age. In 2016 the last of these reports was published. Although there were no differences in the primary outcome overall, analyses of secondary outcomes and data subsets following a pulse oximeter revision show significant treatment differences between targeting a lower compared with a higher SpO2.
  
  
  CONCLUSIONS
  NeOProM represents the largest collaborative clinical research study of SpO2 targets in extremely low-gestational-age neonates. Although aggregate results give us some insight into the feasibility and efficacy of SpO2 targeting in this population, many questions remain. A patient-level analysis, tracking individual outcomes based on actual SpO2 experienced, may shed some light on these questions. However, finding a single optimal SpO2 range seems unlikely.
authors.affiliation: aDepartment of Pediatrics, The Children's Hospital at Albany Medical Center, Albany bDepartment of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, New York, New York, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Cummings
authors.forename: Satyan
authors.initials: S
authors.lastname: Lakshminrusimha
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D010100:Oxygen