Similar adverse outcome rates with high or low oxygen saturation targets in an area with low background mortality

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Nina Willgerodt - , Universität Leipzig (Autor:in)
  • Christoph Bührer - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Rainer Rossi - , Vivantes Klinikum Neukölln (Autor:in)
  • Thomas Kühn - , Vivantes Klinikum Neukölln (Autor:in)
  • Mario Rüdiger - , Klinik und Poliklinik für Kinder- und Jugendmedizin (Autor:in)
  • Stefan Avenarius - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Ralf Böttger - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Dirk M. Olbertz - , Klinikum Südstadt Rostock (Autor:in)
  • Hans Proquitte - , Friedrich-Schiller-Universität Jena (Autor:in)
  • Hans Jörg Bittrich - , Fresenius AG (Autor:in)
  • Roland Haase - , Martin-Luther-Universität Halle-Wittenberg, Helios Klinikum Duisburg (Autor:in)
  • Matthias Fröhlich - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Sybille Höhne - , Helios Klinikum Duisburg (Autor:in)
  • Ulrich H. Thome - , Universität Leipzig (Autor:in)

Abstract

Background: Randomized controlled trials have indicated reduced mortality rates in very preterm infants assigned to high compared to low oxygen saturation (SpO2) target levels, accompanied by higher rates of retinopathy of prematurity and bronchopulmonary dysplasia. However, the benefit-to-harm ratio may depend on the local background mortality risk. We therefore aimed to quantify the risk–benefit ratios of different SpO2 target ranges in 10 tertiary newborn intensive care units (NICUs) in East Germany. Methods: In a retrospective multicenter study, 1,399 infants born between 2008 and 2012 at a gestational age between 24 0/7 and 27 6/7 weeks and with a birthweight below 1,250 g were grouped according to the hospital's target SpO2 range [high oxygen saturation group (HOSG) above 90%], low oxygen saturation group (LOSG) below 90%] and the compliance of units with their target SpO2 range. The association between neonatal morbidities, neurodevelopmental outcomes, selected treatment strategies, and target SpO2 ranges was calculated using chi-squared and Mann Whitney U tests. Results: Nine of the ten participating NICUs met their SpO2 target ranges. Five units were considered as HOSG, and five units were considered as LOSG. Necrotizing enterocolitis and intraventricular hemorrhage grade ≥ 2 occurred significantly more frequently in the HOSG than in the LOSG (8.4% vs. 5.1%, p = 0.02; and 26.6% vs. 17.7%, p < 0.001). No significant differences in the mortality rate and the rate of retinopathy of prematurity were found. Conclusion: In our patient population, a lower SpO2 target range was not associated with increased safety risks in extremely preterm infants. We cannot be sure that our outcome differences are associated with differences in oxygen saturations due to the retrospective study design and the differences in site practices.

Details

OriginalspracheEnglisch
Aufsatznummer1235877
FachzeitschriftFrontiers in pediatrics
Jahrgang11
PublikationsstatusVeröffentlicht - 2023
Peer-Review-StatusJa

Schlagworte

Schlagwörter

  • bronchopulmonary dysplasia, intraventricular hemorrhage, mortality, necrotizing enterocolitis, oxygen dilemma, oxygen saturation, preterm infant, retinopathy of prematurity