Objective: To evaluate the heart rate (HR) and oxygen saturation (SpO2) at 15-second intervals within 60 seconds after incremental increases of fractional inspired oxygen (FiO2) during resuscitation of infants younger than 29 weeks requiring two different forms of ventilatory support.
Study design: Retrospective observational study.
Methods: Forty-three infants were stabilized, 14 by continuous positive airway pressure exclusively (CPAP group), and 29 by positive pressure ventilation (PPV group). Both groups received ventilatory support in a special bed with two cameras enabling the evaluation of all interventions including HR, SpO2, FiO2, positive inflation pressure, and positive end-expiratory pressure values. FiO2 was commenced at 0.30 and titrated in 0.1-0.2 increments every 30-60 seconds. The relationships between the incremental increases of FiO2 and related SpO2 and HR changes were evaluated.
Results: Although there was an inverse correlation between initial FiO2 and SpO2 in both groups, a significant positive correlation between the incremental increase of FiO2 and SpO2 changes after 30 seconds was found only in the CPAP group. Only higher initial levels of FiO2 had a positive effect on the improvement in SpO2 in the PPV group.
Conclusion: The efficacy of FiO2 titration in 0.1-0.2 increments may be attenuated and delayed in extremely preterm infants required PPV during the first 6 minutes of life.
Keywords: FiO(2) titration; delivery room; extremely premature infants; ventilatory support.
Copyright © 2013. Published by Elsevier B.V.