Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.
Acta Paediatr. 2019 Sep;108(9):1584-1589. doi: 10.1111/apa.14808. Epub 2019 Apr 25.
European consensus guidelines published in May 2013 recommended a target peripheral capillary oxygen saturation (SpO ) range of 90-95% for preterm infants. These were incorporated into guidelines at the Karolinska University Hospital, Sweden, in November 2013. This study compared clinical practice before and after those local guidelines.
We included infants who were born between 23 + 0 and 30 + 6 weeks from January 1, 2013 to December, 31 2015 and received intensive care in two Karolinska units. The lower saturation target of 88-92% and alarm limits of 85-95% used before November 2013 were compared to the new higher saturation target of 90-95% and alarm limits of 89-96%.
Data from 399 infants were analysed. The mean SpO was 92.4% with the higher target (n = 301) and 91.1% with the lower target (n = 98). Using the higher instead of lower target meant that the SpO was within the prescribed target range more frequently (51% versus 30%) and the proportion of time with SpO >95% was increased by 9% (95% confidence interval 7-11%, p < 0.001).
The higher saturation target and tighter alarm limits led to higher mean oxygen saturation, increased adherence to the target and increased time with hyperoxaemia.
2013 年 5 月发布的欧洲共识指南建议早产儿的外周毛细血管血氧饱和度（SpO ）目标范围为 90-95%。这些建议于 2013 年 11 月纳入瑞典卡罗林斯卡大学医院的指南。本研究比较了这些当地指南前后的临床实践。
我们纳入了 2013 年 1 月 1 日至 2015 年 12 月 31 日期间出生于 23+0 至 30+6 周龄并在两个卡罗林斯卡单位接受重症监护的婴儿。比较了 2013 年 11 月之前使用的 88-92%的较低饱和度目标和 85-95%的报警限与新的 90-95%的较高饱和度目标和 89-96%的报警限。
分析了 399 名婴儿的数据。较高目标（n=301）的 SpO 平均为 92.4%，较低目标（n=98）的 SpO 平均为 91.1%。使用较高目标而非较低目标意味着 SpO 更频繁地处于规定的目标范围内（51%比 30%），SpO>95%的时间比例增加了 9%（95%置信区间为 7-11%，p<0.001）。
较高的饱和度目标和更严格的报警限导致平均氧饱和度升高，目标的依从性增加，高氧血症的时间增加。
