COMMENTARY

Oxygen Saturation in Preterm Infants: Hitting the Target

Laura A. Stokowski, RN, MS

Disclosures

February 06, 2014

In This Article

Oxygen Saturation Targeting in Preterm Infants Receiving Continuous Positive Airway Pressure

Lim K, Wheeler KI, Gale TJ, et al
J Pediatr. 2014 Jan 13. [Epub ahead of print]

Oxygen Saturation Targets

The near-instantaneous data provided by pulse oximetry have enabled us to administer oxygen more judiciously, particularly to preterm infants, in an attempt to strike a balance between the harms caused by too much (retinopathy of prematurity, chronic lung disease) and too little (neurologic damage, death) oxygen. To avoid the extremes of oxygenation, targets for desired oxygenation levels are cocooned within the boundaries of high and low alarm limits that alert staff when an infant drifts outside of these parameters, permitting an appropriate clinical response that often involves an adjustment of the fraction of inspired oxygen (FiO2) concentration.

Unfortunately, in practice, it's not as straightforward as it sounds. In fact, the optimal oxygen saturation levels for preterm infants have been called "a moving target,"[1] fluctuating almost as much as our patients' SpO2 levels. Reaching a consensus on what these levels should be is still a work in progress.

Regardless of how those targets are defined, maintaining a baby's oxygen saturation levels within targeted ranges has proved to be a difficult task, one that typically rests on the shoulders of the neonatal intensive care unit (NICU) nurse. Research consistently shows that infants spend significant amounts of time outside of the desired ranges for SpO2.

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