Association of response time and intermittent hypoxemia in extremely preterm infants

Acta Paediatr. 2023 Jul;112(7):1413-1421. doi: 10.1111/apa.16766. Epub 2023 Apr 1.

Abstract

Aim: To determine the relationship between medical staff's response time (RT) to oxygen saturation (SpO2 ) below 80% and the associated time from tactile intervention until SpO2 normalisation (CT).

Methods: Time-lapse video and continuous SpO2 were recorded for six consecutive 24 h periods. Regression analyses of RT and SpO2 in association with postmenstrual age (PMA), weight, infant sex and frequency of intermittent hypoxemia (IH).

Results: Five hundred and twelve hypoxemia episodes received tactile intervention in 20 extremely preterm infants (gestational age ≤28 weeks, birthweight <1500 g). Median RT was 20.5 s (IQR 16.63-25.50). RT increased with increased IH frequency (p = 0.023) independently of PMA and weight. SpO2 decreased by 3.7% with every 10 s RT (p = 0.039). Time until SpO2 normalisation was strongly associated with RT (β = 0.58, p = 0.042). The association was amplified by lower PMA (p = 0.043). Female preterm infants experienced longer RT than males (p = 0.027). Because the total length of an IH is the sum of RT and CT, preterm infants with low PMA can reach a critical hypoxemia duration of >60 s, even with short RT.

Conclusion: The RT is a critical factor that affects the overall time of IH treatments and the depth of desaturation. The consequences of a prolonged RT are worse for more immature preterm infants.

MeSH terms

  • Female
  • Gestational Age
  • Humans
  • Hypoxia / complications
  • Infant
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • Oximetry
  • Oxygen*
  • Reaction Time

Substances

  • Oxygen