Kaufman David A, Zanelli Santina A, Gurka Matthew J, Davis Michael, Richards Charles P, Walsh Brian K
Department of Pediatrics University of Virginia School of Medicine, Charlottesville, VA, USA.
Department of Pediatrics University of Virginia School of Medicine, Charlottesville, VA, USA.
Early Hum Dev. 2014 Sep;90 Suppl 2:S35-40. doi: 10.1016/S0378-3782(14)50010-2.
To better understand the impact of hypoxia and hyperoxia on neonatal morbidity and mortality, we examined the number of hypoxia and hyperoxia events as well as percentage of time spent outside oxygen saturation targets in relationship to threshold retinopathy of prematurity (tROP) and mortality in preterm infants.
Saturation data in 2-second sampling from pulse oximeters was prospectively collected in a single NICU. Average SaO2, low and high saturation events, duration of events, and percentage of time infants spent outside of oxygen saturation range were collected and analyzed continuously during the hospitalization.
102 infants <1500g or <32 weeks gestation were enrolled. There were 125, 112, and 43 hypoxia events/day and 106, 80, and 34 hyperoxia events/day for tROP (N=8), non-survivor (N=16) and non-tROP patients (N=78), respectively. Infants were outside saturation targets for 2:35, 1:38, and 1:03 (hypoxia) and 2:02, 1:25, and 0:38 hours/day (hyperoxia) for tROP, non-survivor and non-tROP, respectively. Time spent outside saturation range (hypoxia, hyperoxia and total time) for the hospital course was higher in tROP (P≤0.006) and non-survivor (P≤0.005) compared with non-tROP patients. The three groups defined themselves in the first 10 days after birth, with regard to duration of hypoxia (P=0.0003), hyperoxia (P=0.0004) and total time outside the targeted saturation range (P=0.0006).
Information such as the duration and number of hypoxia and hyperoxia events, as well as total time outside the targeted saturation range, could be factored into assessing clinical interventions and research studies in the prevention, treatment and evaluation of neonatal outcomes.
为了更好地理解缺氧和高氧对新生儿发病率和死亡率的影响，我们研究了缺氧和高氧事件的数量以及在氧饱和度目标范围之外所花费的时间百分比与早产儿阈值性视网膜病变（tROP）和死亡率之间的关系。
在一家新生儿重症监护病房（NICU）前瞻性收集来自脉搏血氧仪的2秒采样饱和度数据。在住院期间持续收集并分析平均血氧饱和度（SaO2）、低饱和度和高饱和度事件、事件持续时间以及婴儿在氧饱和度范围之外所花费的时间百分比。
纳入了102例出生体重<1500g或胎龄<32周的婴儿。对于tROP组（N = 8）、非存活者组（N = 16）和非tROP组患者（N = 78），每天的缺氧事件分别为125、112和43次，高氧事件分别为106、80和34次。对于tROP组、非存活者组和非tROP组，婴儿在氧饱和度目标范围之外的时间分别为每天2小时35分钟、1小时38分钟和1小时03分钟（缺氧情况）以及每天2小时02分钟、1小时25分钟和0小时38分钟（高氧情况）。与非tROP组患者相比，tROP组（P≤0.006）和非存活者组（P≤0.005）在住院期间处于饱和度目标范围之外的时间（缺氧、高氧及总时间）更长。在出生后的前10天，三组在缺氧持续时间（P = 0.0003）、高氧持续时间（P = 0.0004）和目标饱和度范围之外的总时间（P = 0.0006）方面表现出差异。
诸如缺氧和高氧事件的持续时间和数量以及在目标饱和度范围之外的总时间等信息，可用于评估预防、治疗和评估新生儿结局的临床干预措施及研究。
