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In Search of the Optimal Oxygen Saturation for Extremely Low Birth Weight Infants: A Systematic Review and Meta-Analysis.
MedLine Citation:
PMID:  21150224     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: The optimal arterial oxygen saturation in the first weeks of life is unknown for immature newborn infants. Objectives: To determine the effect of targeting high versus low oxygen saturation in the first weeks of life on the outcome of very low and extremely low birth weight infants. Methods: Randomized and observational studies were sought that compared the outcomes in babies with high or low oxygen saturation targeting assessed by pulse oximetry. Results: Ten studies were identified, of which 8 had severe retinopathy of prematurity (n = 3,674) and 8 had bronchopulmonary dysplasia/lung problems (n = 4,475) as outcomes. Two studies also provided survival data. The relative risk (RR) in favor of low SpO(2) was 0.42 (95% CI 0.34-0.51) for severe retinopathy of prematurity, 0.73 (95% CI 0.63-0.86) for bronchopulmonary dysplasia/lung problems, and 1.12 (95% CI 0.86-1.45) for mortality. There was 1 randomized trial with retinopathy of prematurity, 3 with bronchopulmonary dysplasia/lung problems, and 1 with mortality as the outcome. When analyzing the randomized trial separately, the RR (95% CI) for severe retinopathy of prematurity was 0.48 (0.34-0.68), for bronchopulmonary dyslasia/lung problems it was 0.79 (0.64-0.97), and for mortality it was 1.27(1.01-1.60). Conclusions: A low oxygen saturation approach reduces severe retinopathy of prematurity by 50%, i.e. from 20.9 to 9.5%, and bronchopulmonary dysplasia/lung problems by 25%, i.e. from 40.8 to 29.7%. Further randomized trials are needed to provide definite conclusions and to assess whether reducing oxygen saturation has an impact on mortality among very and extremely low birth weight infants.
Authors:
Ola Didrik Saugstad; Dagfinn Aune
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-09
Journal Detail:
Title:  Neonatology     Volume:  100     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-8     Citation Subset:  -    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Department of Pediatric Research, Rikshospitalet, Oslo University Hospital, University of Oslo, Oslo, Norway.
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