极早产儿5分钟血氧饱和度与新生儿死亡及脑室内出血之间的关联。
Association between 5-minute oxygen saturation and neonatal death and intraventricular hemorrhage among extremely preterm infants.
作者信息
Jiang Siyuan, Cui Xin, Katheria Anup, Finer Neil N, Bennett Mihoko V, Profit Jochen, Lee Henry C
机构信息
Division of Neonatology, University of California San Diego, La Jolla, CA, USA.
Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
出版信息
J Perinatol. 2024 Dec 11. doi: 10.1038/s41372-024-02194-w.
OBJECTIVE
To assess the relationship between 5-min oxygen saturation (SpO2) and outcomes in extremely preterm infants.
STUDY DESIGN
This cohort study included infants ≤28 weeks' gestation across nine hospitals from 2020 to 2022. Death and / or severe intraventricular hemorrhage (IVH) were compared between infants with 5-min SpO2 < 80% and 80-100% using Poisson regression models. Receiver Operating Characteristic (ROC) curve and optimal breakpoint analysis were used to estimate the optimal breakpoint of 5-min SpO2 in relation to outcomes.
RESULT
Of 390 infants, 184 (47.2%) had 5-min SpO2 < 80%. A 5-min SpO2 < 80% was independently associated with increased risks of death and / or severe IVH, early death, and severe IVH. ROC analysis of 5-min SpO2 identified optimal breakpoint at 81-85%, above which no additional benefit in outcomes was observed.
CONCLUSION
Our findings support the current recommendation of 5-min SpO2 target of ≥80% for extremely preterm infants.
目的
评估极早产儿5分钟血氧饱和度（SpO2）与预后之间的关系。
研究设计
这项队列研究纳入了2020年至2022年期间9家医院中孕周≤28周的婴儿。使用泊松回归模型比较5分钟SpO2<80%和80-100%的婴儿的死亡和/或重度脑室内出血（IVH）情况。采用受试者工作特征（ROC）曲线和最佳断点分析来估计与预后相关的5分钟SpO2的最佳断点。
结果
在390名婴儿中，184名（47.2%）的5分钟SpO2<80%。5分钟SpO2<80%与死亡和/或重度IVH、早期死亡以及重度IVH风险增加独立相关。对5分钟SpO2进行的ROC分析确定最佳断点为81-85%，高于此值未观察到预后有额外益处。
结论
我们的研究结果支持目前对极早产儿5分钟SpO2目标≥80%的建议。
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