Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA.
J Pediatr. 2012 Dec;161(6):1047-52. doi: 10.1016/j.jpeds.2012.05.046. Epub 2012 Jun 26.
To test the hypothesis that preterm infants randomized to a low vs high O(2) saturation target range have a higher incidence of intermittent hypoxemia.
A subcohort of 115 preterm infants with high resolution pulse oximetry enrolled in the Surfactant, Positive Pressure, and Oxygenation Randomized Trial were randomized to low (85%-89%) or high (91%-95%) O(2) saturation target ranges. Oxygen saturation was monitored until 36 weeks postmenstrual age or until the infant was breathing room air without respiratory support for ≥72 hours.
The low target O(2) saturation group had a higher rate of intermittent hypoxemia (≤80% for ≥10 seconds and ≤3 minutes) prior to 12 days and beyond 57 days of life (P < .05). The duration shortened (P < .0001) and the severity increased (P < .0001) with increasing postnatal age with no differences between target saturation groups. The higher rate of intermittent hypoxemia events in the low target group was associated with a time interval between events of <1 minute.
A low O(2) saturation target was associated with an increased rate of intermittent hypoxemia events that was dependent on postnatal age. The duration and severity of events was comparable between target groups. Further investigation is needed to assess the role of intermittent hypoxemia and their timing on neonatal morbidity.
检验以下假说，即将早产儿随机分为低氧饱和度目标范围与高氧饱和度目标范围，前者发生间歇性低氧血症的概率是否更高。
一项高分辨率脉搏血氧饱和度监测的亚组研究纳入了表面活性物质、正压通气和氧合随机试验中的 115 名早产儿，这些早产儿被随机分为低（85%-89%）或高（91%-95%）氧饱和度目标范围。监测氧饱和度直至校正胎龄 36 周或婴儿在无需呼吸支持的情况下能自主呼吸空气≥72 小时。
低目标氧饱和度组在出生后 12 天前和 57 天后（P<.05）更易发生间歇性低氧血症（≤80%持续时间≥10 秒且≤3 分钟）。随着出生后时间的延长，间歇性低氧血症的持续时间缩短（P<.0001），严重程度增加（P<.0001），但目标饱和度组之间无差异。低目标组间歇性低氧血症事件发生率更高，其事件之间的时间间隔<1 分钟。
低氧饱和度目标与间歇性低氧血症事件发生率增加有关，且这种增加与出生后时间有关。事件的持续时间和严重程度在目标组之间无差异。需要进一步研究来评估间歇性低氧血症及其发生时间对新生儿发病率的影响。
