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Title: Targeted Oxygen Therapy in Special Care Nurseries: Is Uniformity a Good Thing?
Authors: Buckmaster, Adam ;Arnolda, G.R.B.;Wright, Ian ;Foster, Jann 
Issue Date: 2012
Source: Volume 48, Issue 6, pp. 476-482
Journal title: Journal of Paediatrics & Child Health
Abstract: AIM: There is wide variation in the commencement of inspired oxygen (FiO2) and the oxygen saturation (SpO(2) ) targets set in special care nurseries (SCNs). Evidence supports minimising unnecessary oxygen exposure. Does the introduction of a protocol advocating the uniform approach of commencing FiO2 at 30% and targeting SpO2 of 94-96% for infants >= 33 weeks gestation with respiratory distress reduce oxygen exposure? METHODS: A 'Before After' study was undertaken in three SCNs. Data were recorded for all infants admitted to the SCNs who required oxygen over a 3-year period. Infants were analysed in gestational age groups: 33-36 weeks (late preterm) and +37 weeks (term/post-term). RESULTS: Of the 19,830 infants born, 868 (4%) were treated with oxygen. The introduction of an oxygen-targeting protocol resulted in a statistically and clinically significant reduction in the proportion of infants who were treated with any oxygen for 1 h or more, 4 h or more and in the proportion who received >30% FiO2 for 1 h or more (all P <= 0.01). This reduction was significant for infants of both gestational age groups. The median duration of oxygen for term/post-term infants was reduced from 12 h pre-protocol to 10 h post-protocol (P= 0.01); however, no significant difference was found for the preterm group (reduced from 11 to 8 h, P= 0.07). CONCLUSION: Introduction of a uniform oxygen protocol in SCNs for infants >= 33 weeks gestation with respiratory distress reduces the number of infants receiving oxygen and, in term infants, the duration of oxygen exposure.
DOI: 10.1111/j.1440-1754.2011.02220.x.
ISSN: 1440-1754
Publicaton type: Journal Article
Keywords: Newborn and Infant
Appears in Collections:Obstetrics / Paediatrics

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