Outcomes of oxygen saturation targeting during delivery room stabilisation of preterm infants

Data de publicació: 01/09/2018 Data Ahead of Print: 07/10/2017

Autors de IIS La Fe

Máximo Vento Torres

Autor

Autors aliens a IIS La Fe

Oei, JL
Finer, NN
Saugstad, OD
Wright, IM
Rabi, Y
Tarnow-Mordi, W
Rich, W
Kapadia, V
Rook, D
Smyth, JP
Lui, K

Grups d'Investigació

Perinatología

Leader

Máximo Vento Torres

Abstract

Objective To determine the association between SpO(2) at 5 min and preterm infant outcomes. Design Data from 768 infants <32 weeks gestation from 8 randomised controlled trials (RCTs) of lower (<= 0.3) versus higher (>= 0.6) initial inspiratory fractions of oxygen (FiO(2)) for resuscitation, were examined. Setting Individual patient analysis of 8 RCTs Interventions Lower (<= 0.3) versus higher (>= 0.6) oxygen resuscitation strategies targeted to specific predefined SpO 2 before 10 min of age. Patients Infants <32 weeks gestation. Main outcome measures Relationship between SpO(2) at 5 min, death and intraventricular haemorrhage (IVH) > grade 3. Results 5 min SpO(2) data were obtained from 706 (92%) infants. Only 159 (23%) infants met SpO(2) study targets and 323 (46%) did not reach SpO(2) 80%. Pooled data showed decreased likelihood of reaching SpO 2 80% if resuscitation was initiated with FiO(2) <0.3 (OR 2.63, 95% CI 1.21 to 5.74, p<0.05). SpO(2) <80% was associated with lower heart rates (mean difference -8.37, 95% CI -15.73 to -1.01, * p<0.05) and after accounting for confounders, with IVH (OR 2.04, 95% CI 1.01 to 4.11, p<0.05). Bradycardia (heart rate <100 bpm) at 5 min increased risk of death (OR 4.57, 95% CI 1.62 to 13.98, p<0.05). Taking into account confounders including gestation, birth weight and 5 min bradycardia, risk of death was significantly increased with time taken to reach SpO(2) 80%. Conclusion Not reaching SpO(2) 80% at 5 min is associated with adverse outcomes, including IVH. Whether this is because of infant illness or the amount of oxygen that is administered during stabilisation is uncertain and needs to be examined in randomised trials

Dades de la publicació

ISSN/ISSNe:: 1359-2998, 1468-2052
Tipus:: Article
Pàgines:: 446-454
DOI:: 10.1136/archdischild-2016-312366
PubMed:: 28988158
Factor d'Impacte:: 1,555 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Oei, JL:: Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia

School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia

Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia

Royal Hosp Women, Dept Newborn Care, Randwick, NSW 2031, Australia

Univ New South Wales, Sch Womens & Childrens Hlth, Randwick, NSW, Australia

Univ Sydney, Clin Trials Ctr, Camperdown, NSW, Australia
Finer, NN:: Department of Pediatrics, Neonatology, University of California, San Diego, California, USA

Sharp Mary Birch Hospital for Women and Newborns, San Diego, California, USA

Univ Calif San Diego, Dept Pediat, Neonatol, San Diego, CA 92103 USA

Sharp Mary Birch Hosp Women & Newborns, San Diego, CA USA
Saugstad, OD:: Department of Pediatric Research, The University of Oslo, Oslo University Hospital, Oslo, Norway

Univ Oslo, Oslo Univ Hosp, Dept Pediat Res, Oslo, Norway
Wright, IM:: Illawarra Health and Medical Research Institute and Graduate Medicine, The University of Wollongong, Wollongong, New South Wales, Australia

Univ Wollongong, Illawarra Hlth & Med Res Inst, Wollongong, NSW, Australia

Univ Wollongong, Grad Med, Wollongong, NSW, Australia
Rabi, Y:: Department of Neonatology, University of Calgary, Alberta, Canada

Alberta Children's Hospital Research Institute, Alberta, Canada

Univ Calgary, Dept Neonatol, Calgary, AB, Canada

Alberta Childrens Hosp Res Inst, Calgary, AB, Canada
Tarnow-Mordi, W:: Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia

Univ Sydney, Clin Trials Ctr, Camperdown, NSW, Australia
Rich, W:: Sharp Mary Birch Hospital for Women and Newborns, San Diego, California, USA

Sharp Mary Birch Hosp Women & Newborns, San Diego, CA USA
Kapadia, V:: Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA

UT Southwestern Med Ctr, Div Neonatal Perinatal Med, Dallas, TX USA
Rook, D:: Department of Pediatrics, Neonatology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands

Sophia Childrens Univ Hosp, Erasmus Med Ctr, Dept Pediat, Neonatol, Rotterdam, Netherlands
Smyth, JP:: Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia

School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia

Royal Hosp Women, Dept Newborn Care, Randwick, NSW 2031, Australia

Univ New South Wales, Sch Womens & Childrens Hlth, Randwick, NSW, Australia
Lui, K:: Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia

School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia

Royal Hosp Women, Dept Newborn Care, Randwick, NSW 2031, Australia

Univ New South Wales, Sch Womens & Childrens Hlth, Randwick, NSW, Australia
Vento, M:: Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain

Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain