Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21460%2F20%3A00342122" target="_blank" >RIV/68407700:21460/20:00342122 - isvavai.cz</a>
Result on the web
<a href="https://doi.org/10.1186/s12887-020-02225-3" target="_blank" >https://doi.org/10.1186/s12887-020-02225-3</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1186/s12887-020-02225-3" target="_blank" >10.1186/s12887-020-02225-3</a>
Alternative languages
Result language
angličtina
Original language name
Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity
Original language description
BackgroundContinuous monitoring of SpO(2) in the neonatal ICU is the standard of care. Changes in SpO(2) exposure have been shown to markedly impact outcome, but limiting extreme episodes is an arduous task. Much more complicated than setting alarm policy, it is fraught with balancing alarm fatigue and compliance. Information on optimum strategies is limited.MethodsThis is a retrospective observational study intended to describe the relative chance of normoxemia, and risks of hypoxemia and hyperoxemia at relevant SpO(2) levels in the neonatal ICU. The data, paired SpO(2)-PaO2 and post-menstrual age, are from a single tertiary care unit. They reflect all infants receiving supplemental oxygen and mechanical ventilation during a 3-year period. The primary measures were the chance of normoxemia (PaO2 50-80mmHg), risks of severe hypoxemia (PaO2 <= 40mmHg), and of severe hyperoxemia (PaO2 >= 100mmHg) at relevant SpO(2) levels.ResultsNeonates were categorized by postmenstrual age: <33 (n=155), 33-36 (n=192) and>36 (n=1031) weeks.From these infants, 26,162 SpO(2)-PaO2 pairs were evaluated. The post-menstrual weeks (median and IQR) of the three groups were: 26 (24-28) n=2603; 34 (33-35) n=2501; and 38 (37-39) n=21,058. The chance of normoxemia (65, 95%-CI 64-67%) was similar across the SpO(2) range of 88-95%, and independent of PMA. The increasing risk of severe hypoxemia became marked at a SpO(2) of 85% (25, 95%-CI 21-29%), and was independent of PMA. The risk of severe hyperoxemia was dependent on PMA. For infants <33weeks it was marked at 98% SpO(2) (25, 95%-CI 18-33%), for infants 33-36weeks at 97% SpO(2) (24, 95%-CI 14-25%) and for those >36weeks at 96% SpO(2) (20, 95%-CI 17-22%).ConclusionsThe risk of hyperoxemia and hypoxemia increases exponentially as SpO(2) moves towards extremes.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
20601 - Medical engineering
Result continuities
Project
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Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2020
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
BMC Pediatrics
ISSN
1471-2431
e-ISSN
1471-2431
Volume of the periodical
20
Issue of the periodical within the volume
1
Country of publishing house
GB - UNITED KINGDOM
Number of pages
8
Pages from-to
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UT code for WoS article
000545984000006
EID of the result in the Scopus database
2-s2.0-85087157047