Alapati Deepthi, Jassar Romal, Shaffer Thomas H
Department of Pediatrics, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware.
Am J Perinatol. 2017 Feb;34(3):276-282. doi: 10.1055/s-0036-1586754. Epub 2016 Aug 4.
To evaluate practice variations amongst neonatologists regarding oxygen management in neonates with persistent pulmonary hypertension of newborn (PPHN). An online survey was administered to neonatologists to assess goal oxygenation targets and oxygen titration practices in PPHN. Response variations were assessed and intergroup comparisons performed. Thirty-three percent (492) of neonatologists completed the survey. Twenty-eight percent reported using specific oxygen titration guidelines. Majority of respondents used a combination of oxygen saturation (SpO) and arterial oxygen tension (PaO) initially to titrate oxygen. Seventy percent of the respondents used higher goal SpO > 95% or 95 to 98% and thirty-eight percent of the respondents used PaO > 80 mm Hg. Physicians with extracorporeal membrane oxygenation experience and those with greater than ten years neonatal intensive care unit experience inclined toward use of SpO alone for oxygen titration and aimed for lower range of SpO and PaO targets. Greater proportion of neonatologists who employed specific oxygen titration guidelines used lower SpO targets. Wide practice variations exist amongst neonatologists regarding optimal SpO and PaO targets and oxygen titration practices in the management of PPHN.
评估新生儿科医生在新生儿持续性肺动脉高压（PPHN）氧疗管理方面的实践差异。 对新生儿科医生进行了一项在线调查，以评估PPHN的目标氧合指标和氧滴定实践。评估了应答差异并进行了组间比较。 33%（492名）新生儿科医生完成了调查。28%的医生报告使用特定的氧滴定指南。大多数受访者最初使用氧饱和度（SpO）和动脉血氧分压（PaO）相结合的方法来滴定氧气。70%的受访者使用较高的目标SpO>95%或95至98%，38%的受访者使用PaO>80 mmHg。有体外膜肺氧合经验的医生以及有超过十年新生儿重症监护病房经验的医生倾向于仅使用SpO进行氧滴定，并将SpO和PaO目标设定在较低范围。采用特定氧滴定指南的新生儿科医生中，更大比例的人使用较低的SpO目标。 在PPHN管理中，新生儿科医生在最佳SpO和PaO目标以及氧滴定实践方面存在广泛的实践差异。
