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  • Original Article
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Temporal quantification of oxygen saturation ranges: an effort to reduce hyperoxia in the neonatal intensive care unit

Abstract

Objective:

To reduce exposure to hyperoxia and its associated morbidities in preterm neonates.

Study design:

A multidisciplinary group was established to evaluate oxygen exposure in our neonatal intensive care unit. Infants were assigned target saturation ranges and signal extraction technology implemented to temporally quantify achievement of these ranges. The outcomes bronchopulmonary dysplasia/death, retinopathy of prematurity (ROP)/death, severe ROP and ROP requiring surgery were compared in a pre- versus post-intervention evaluation using multivariate analyses.

Result:

A total of 304 very low birth weight pre-initiative infants were compared with 396 post-initiative infants. Multivariate analyses revealed decreased odds of severe ROP (adjusted odds ratio (OR): 0.41; 95% confidence interval (CI): 0.24–0.72) and ROP requiring surgery (adjusted OR 0.31; 95% CI: 0.17–0.59) post-initiative. No differences in death were observed.

Conclusion:

Significant reductions in severe ROP and ROP requiring surgery were observed after staff education and implementation of new technology to quantify success in achieving targeted saturations and reinforce principles and practices.

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Acknowledgements

This publication was made possible by CTSA Grant Number UL1 RR024139 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official of NCRR or NIH. We would like to thank all staff members of the YNHCH NICU for their dedication to this effort and, in particular, the Oxidative Stress Initiative Committee for leading the initiative. They are: Louise Albis, RN, Katherine Blankenbaker, RN, Ana Carneiro, RN, Charlene Cannon-Heinrich, RN, Nancy Koval, NNP, Timothy Mack, RT, Steven Nivison, RT, Emese Pinter, MD, Nancy Ramsey, RT, PA, Barbara E. Sabo, APRN, Marilyn Sellers, RN, Christina Simoes, RN, Victoria Vasquez, RN and Jona Wilson, RN. We would also like to thank Dr Kathleen Stoessel for her dedication in screening and treating all of our NICU population with ROP.

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Correspondence to M J Bizzarro.

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Bizzarro, M., Li, F., Katz, K. et al. Temporal quantification of oxygen saturation ranges: an effort to reduce hyperoxia in the neonatal intensive care unit. J Perinatol 34, 33–38 (2014). https://doi.org/10.1038/jp.2013.122

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