Current Recommendations and Practice of Oxygen Therapy in Preterm Infants

William Tarnow-Mordi; Adrienne Kirby

doi:10.1016/j.clp.2019.05.015

Current Recommendations and Practice of Oxygen Therapy in Preterm Infants

Clin Perinatol. 2019 Sep;46(3):621-636. doi: 10.1016/j.clp.2019.05.015. Epub 2019 Jun 12.

Authors

William Tarnow-Mordi¹, Adrienne Kirby²

Affiliations

¹ NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia. Electronic address: williamtm@med.usyd.edu.au.
² NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.

PMID: 31345552
DOI: 10.1016/j.clp.2019.05.015

Abstract

This narrative review identified 23 publications in 2011 to 2019 discussing randomized trials of oxygen saturation targets of 85% to 89% versus 91% to 95% in infants below 28 weeks' gestation. Of 18 commentaries or consensus statements, 17 recommended saturation targets above 89%. Five systematic reviews reported that the 85% to 89% target increased mortality but not the composite of death or disability. The evidence for increased mortality was assessed as of "high", "moderate," or "low," quality, reflecting substantial differences in interpreting the GRADE guidelines. Systematic reviews and guidelines without biostatisticians or epidemiologists as co-authors should be considered potentially problematic.

Keywords: Extremely premature infant; Infant mortality; Necrotizing enterocolitis; Oximetry; Oxygen; Oxygenation; Retinopathy of prematurity.

Publication types

Review

MeSH terms

Humans
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases / metabolism
Infant, Premature, Diseases / therapy*
Oxygen Inhalation Therapy / standards*
Practice Guidelines as Topic*