Abstracto

Transcutaneous oxygen saturations in former preterm infants breathing in room air at discharge from the NICU

Taha Ben Saad

Former preterm infants who are breathing in ambient air remain at risk for apnea and brief intermittent episodes of hypoxemia. Continuous cardiorespiratory monitoring is therefore provided until the day of discharge. However, intermittent episodes of hypoxemia are frequently self-limited and may set off the low alarm for oxygen saturation (SpO2) only briefly, easily escaping from the observation of the bedside caregiver. Moreover, the accurate lower limit for SpO2 in this population is unknown and often extrapolated from full term infants. By analyzing electronically recorded SpO2, we aimed to define the normal range for SpO2 measurements in these infants and to determine the amount of time SpO2 were below the lower limit of normal. This ongoing prospective, observational study started enrollment in June of 2017. Former preterm infants born <32 weeks of gestational age (GA), who are breathing without additional support in ambient air and are close to discharge were eligible. Enrolled infants were attached to an additional pulse oximeter with a covered display. Only the clinical team caring for the infant determined readiness for discharge as per St. Vincent NICU guidelines. After the infant was discharged, the investigators downloaded and analyzed up to 96 hours of recorded SpO2 measurements from the study oximeter using computer software. Pertinent maternal and neonatal data were collected from the electronic medical record. Mean SpO2 for all studied infants was ? 98%. In 95% of AFRT, infants had SpO2 of 96- 100%. Infants spent < 1% of recording time with SpO2 ? 90% and < 5% with SpO2 ? 95%. These results can now be used to interpret SpO2 recordings in former preterm infants in room air close to discharge. Based on this data, we can create guidelines for safe SpO2 ranges and acceptable time spent below a certain SpO2 target before discharge.