Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

20601 - Medical engineering

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

BMC Pediatrics

ISSN

1471-2431

e-ISSN

1471-2431

Svazek periodika

20

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

8

Strana od-do

—

Kód UT WoS článku

000545984000006

EID výsledku v databázi Scopus

2-s2.0-85087157047