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Lower oxygen saturation mortality risk in preterm infants
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Extremely preterm infants whose oxygen saturation level was 90% with the use of current oximeters had an increased risk death, according to recent study results published in The New England Journal of Medicine.
“Recruitment was stopped early when an interim analysis showed an increased rate of death at 36 weeks in the group with a lower oxygen saturation,” researchers wrote.
The study included three international randomized controlled trials to evaluate the effects of targeting an oxygen saturation of 85% to 89% compared a range of 91% to 95% on disability-free survival at 2 years in infants born before 28 weeks’ gestation. 2,000 infants were enrolled and 1,187 had treatment using the revised oximeter-calibration algorithm.
Researchers found that among using the revised oximeter-calibration algorithm the rate of death was higher in the lower-target group (RR=1.45; 95% CI, 1.15-1.84) than the higher-target group (23.1% vs. 15.9%).
“These findings mean that 14 infants would need to be treated with a higher oxygen-saturation target in order to prevent one death,” researchers wrote.
Researchers also found, of all participants, that those in the lower-target group had a reduced rate of retinopathy of prematurity (RR=0.79; 95% CI, 0.63-1.00) and an increased rate of necrotizing enterocolitis requiring surgery or causing death (RR=1.31; 95% CI, 1.02-1.68).
“In conclusion, preterm infants born before 28 weeks’ gestation with a target oxygen saturation of 85% to 89% had a significantly higher rate of death than did those with a target of 91% to 95% in a subgroup whose treatment involved an oximeter-calibration algorithm similar to that in current use,” researchers wrote. “Our findings strongly favor the avoidance of targeting an oxygen saturation of less than 90% among such infants, according to reading on current oximeters.”
Disclosure: The researchers report no relevant financial disclosures.
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