PAS: Target Oxygen Saturation Levels for Preemies Explored
Different results seen in two studies comparing 85 to 89 percent versus 91 to 95 percent saturation
MONDAY, May 6 (HealthDay News) -- For extremely preterm infants, the optimal target oxygen saturation levels are unclear, according to two studies published online May 5, one in the Journal of the American Medical Association and one in the New England Journal of Medicine, to coincide with presentation at the annual meeting of the Pediatric Academic Societies, held from May 4 to 7 in Washington, D.C.
Barbara Schmidt, M.D., from the Children's Hospital of Philadelphia, and colleagues conducted a randomized, double-blind international study comparing effects of targeting lower (85 to 89 percent) or higher arterial oxygen saturation (91 to 95 percent) on the rates of death and disability at 18 months in 1,201 infants born before 28 gestational weeks. The researchers found that 51.6 percent of those assigned to the lower target range died or survived with disability, compared with 49.7 percent of those assigned to the higher target range (odds ratio, 1.08; P = 0.52). The rate of death was 16.6 and 15.3 percent, respectively (odds ratio, 1.11; P = 0.54).
Ben J. Stenson, M.D., from the University of Edinburgh in the United Kingdom, and colleagues conducted three international randomized, controlled trials comparing lower and higher arterial oxygen saturation on disability-free survival at age 2 years for infants born before 28 weeks of gestation. The researchers found that the rate of death was significantly higher in the lower target range group (23.1 percent) compared with the higher target range group (15.9 percent; relative risk in lower-target group, 1.45).
"Targeting an oxygen saturation below 90 percent with the use of current oximeters in extremely preterm infants was associated with an increased risk of death," Stenson and colleagues write.
Two authors of the Schmidt study disclosed financial ties to Masimo, which manufacture pulse oximeters and partially funded the study. Masimo provided the pulse oximeters for the Stenson study.
Full Text - Schmidt (http://jama.jamanetwork.com/article.aspx?articleid=1684963 )Editorial (http://jama.jamanetwork.com/article.aspx?articleid=1684964 )Full text - Stenson (http://www.nejm.org/doi/full/10.1056/NEJMoa1302298 )Editorial (http://www.nejm.org/doi/full/10.1056/NEJMe1305534 )More Information (http://www.pas-meeting.org/2013DC/default.asp )