Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
University of Southampton School of Medicine, Southampton, UK.
Pediatr Res. 2023 Dec;94(6):2062-2069. doi: 10.1038/s41390-023-02741-9. Epub 2023 Aug 4.
This study aimed to determine patterns of nocturnal pulse oximetry indices in moderate to late preterm infants, and investigate the relationship between oxygen desaturations, the apnoea hypopnoea index, and both corrected gestational and postnatal age.
21 healthy infants born at 32 + 0 - 36 + 6 weeks gestation underwent serial nocturnal pulse oximetry studies and respiratory polygraphy studies until 40 weeks corrected gestational age (CGA). The main outcome measures were number of >3% oxygen desaturations/hour (ODI3), mean oxygen saturations, and number of apnoeas and hypopnoeas/hour.
Median ODI3 increased between weeks 1 and 3 from 49.9 to 85.4/hour (p = 0.017). Mean oxygen saturations reached a corresponding nadir of 96.0% in week 3, then increased to 96.8% in week 6 (p = 0.019). Mixed effects modelling demonstrated that ODI3 and mean saturations were influenced by postnatal age but not CGA (p < 0.05). Desaturations frequently occurred without an apnoea or hypopnoea.
ODI3 rises then falls during the first 8 weeks of life in moderate to late preterm infants, independently of CGA. These interesting preliminary results highlight the importance of further serial data collection to generate age-specific normal ranges, and develop a better understanding of respiratory control in preterm infants.
The frequency of >3% oxygen desaturations (ODI3) in healthy moderate to late preterm infants rises then falls after birth, peaking in postnatal week 3. There is a corresponding nadir in mean saturations. There were significant non-linear relationships between ODI3/mean saturations and postnatal age, but not corrected gestational age. The majority of brief oxygen desaturations occurred without an apnoea or hypopnoea. Normal ranges for oxygen saturation indices are not known in this population. These results demonstrate the need for further serial data collection to generate age-specific normal ranges and inform oxygen prescribing guidelines.
本研究旨在确定中晚期早产儿夜间脉搏血氧饱和度指数的变化模式，并探讨氧减饱和度、呼吸暂停低通气指数与校正胎龄和出生后年龄的关系。
21 名胎龄 32+0 至 36+6 周出生的健康婴儿接受了多次夜间脉搏血氧饱和度研究和呼吸描记术研究，直到校正胎龄 40 周（CGA）。主要观察指标为每小时氧减饱和度＞3%的次数（ODI3）、平均氧饱和度和每小时呼吸暂停和低通气次数。
第 1 周到第 3 周，ODI3 中位数从 49.9 次/小时增加到 85.4 次/小时（p=0.017）。第 3 周平均氧饱和度达到 96.0%的最低点，然后在第 6 周增加到 96.8%（p=0.019）。混合效应模型显示，ODI3 和平均饱和度受出生后年龄影响，但不受 CGA 影响（p＜0.05）。氧饱和度降低通常发生在没有呼吸暂停或低通气的情况下。
中晚期早产儿出生后第 1 至 8 周，ODI3 先升高后降低，与 CGA 无关。这些有趣的初步结果强调了进一步连续数据收集的重要性，以生成特定年龄的正常范围，并更好地了解早产儿的呼吸控制。
健康的中晚期早产儿的＞3%氧减饱和度（ODI3）频率在出生后先升高后降低，在出生后第 3 周达到峰值。平均饱和度也相应降低。ODI3/平均饱和度与出生后年龄呈显著非线性关系，但与校正胎龄无关。大多数短暂的氧减饱和度发生在没有呼吸暂停或低通气的情况下。在该人群中，氧饱和度指数的正常范围尚不清楚。这些结果表明，需要进一步进行连续的数据收集，以生成特定年龄的正常范围，并为氧饱和度的指导方针提供信息。
