Improving manual oxygen titration in preterm infants by training and guideline implementation

Henriette A van Zanten, Steffen C Pauws, Evelien C Beks, Benjamin Stenson, Enrico Lopriore, Arjan B te Pas

Research output: Contribution to journalArticlepeer-review

Abstract

To study oxygen saturation (SpO2) targeting before and after training and guideline implementation of manual oxygen titration, two cohorts of preterm infants <30 weeks of gestation needing respiratory support and oxygen therapy were compared. The percentage of time spent with SpO2 within target range (85-95%) was calculated (%SpO2-wtr). SpO2 was collected every minute when oxygen > 21%. ABCs where oxygen therapy was given were identified and analyzed. After training and guideline implementation the %SpO2-wtr increased (median (IQR)) 48.0(19.6-63.9)% vs 61.9(48.5–72.3)%;p< 0.005), with a decrease in the %SpO2>95% (44.0(27.8–66.2)% vs 30.8(22.6–44.5)%;p< 0.05). There was no effect on the %SpO2< 85% (5.9(2.8 – 7.9)% vs 6.2(2.5 - 8)%;ns) and %SpO2< 80% (1.9(1.0 – 3.0)% vs 1.7(0.8 – 2.6)%; ns). In total 186 ABCs with oxygen therapy before and 168 ABCs after training and guideline implementation occurred. The duration of SpO2 ≤ 80% reduced (2(1-2) vs 1(1-2) minutes;p< 0.05), the occurrence of SpO2>95% did not decrease (73% vs 64%;ns), but lasted shorter (2(0-7) vs 1(1-3) minutes;p< 0.004). Conclusion: Training and guideline implementation in manual oxygen titration improved SpO2 targeting in preterm infants with more time spent within target range and less frequent hyperoxaemia. The durations of hypoxaemia and hyperoxaemia during ABCs were shorter.
Original languageEnglish
JournalEuropean Journal of Pediatrics
Early online date26 Nov 2016
DOIs
Publication statusE-pub ahead of print - 26 Nov 2016

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