Journal of American Association for Pediatric Ophthalmology and Strabismus
Major articleLower Oxygen Saturation Alarm Limits Decrease the Severity of Retinopathy of Prematurity
Section snippets
Methods
Before June 1, 2003, oxygen saturation alarm limits at the Brigham and Women’s Hospital NICU were set at 87% and 97% for all infants, without a specified target range. Oximetry alarm limits were lowered on June 1, 2003, to 85% and 93% for infants with a birth weight 1250 g or less and/or gestational age 28 weeks or less. Target oxygen saturations were set at 90% to 92%. All infants were monitored throughout the study period using the same oximetry technology (Masimo®; Masimo Corp., Irvine, CA).
Results
Table 1 shows the number of eligible infants per study year. Mean gestational age at birth and birth weight were similar across the years studied. The overall mean gestational age for the group with higher alarm limits was the same (27.3 weeks) as the mean gestational age for the group with lower alarm limits (27.3 weeks). The mean birth weights were also similar for the two groups (919 g vs 945 g, p = 0.43), and the proportion of screened infants with a birth weight less than 1000 g did not vary
Discussion
Oxygen administration is a necessary therapy for VLBW infants, but the optimal and safest level of oxygen saturation is unknown. NICU policies on oxygen administration, oximetry alarm settings, and monitoring vary widely. Many NICUs attempt to target oxygen saturations of 90% to 95%, with lower alarm limits set as low as 75%, and upper limits as high as 100%.7 Our NICU policy did not fall at either end of this spectrum, and we instituted only a small change in a select group of patients. Our
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