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A randomised crossover study of low-flow air or oxygen via nasal cannulae to prevent desaturation in preterm infants
  1. Conor C Hensey1,
  2. Eoghan Hayden1,
  3. Colm Patrick Finbarr O'Donnell1,2,3
  1. 1Department of Neonatology, The National Maternity Hospital, Dublin, Ireland
  2. 2National Children's Research Centre, Dublin, Ireland
  3. 3School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
  1. Correspondence to Dr Colm Patrick Finbarr O'Donnell, Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Ireland; codonnell{at}nmh.ie

Abstract

Objective To compare the efficacy of low-flow oxygen, low-flow air and sham treatment given via nasal cannulae in preventing desaturation (falls in oxygen saturation (SpO2)) in preterm infants.

Study design Infants born at <33 weeks gestation receiving gas at flow rates <1 l/min via nasal cannulae were eligible for inclusion. Enrolled infants received three treatments—0.1 l/min 100% oxygen, 0.1 l/min air, (21% oxygen) and sham (tubing disconnected from flow-meter)—via nasal cannulae, each for 3 h. Treatments were given in a randomly assigned order and caregivers were masked to treatment. Infants were monitored with a pulse oximeter that recorded SpO2 and heart rate every 2 s. Treatment was stopped before 3 h if infants reached prespecified failure criteria. We compared the rates of failure and the frequency and duration of desaturation episodes that occurred during each treatment.

Results Of 14 infants enrolled, 2 (14%) reached failure criteria during treatment with oxygen compared with 7 (50%) during treatment with air and sham. Among infants who completed the 3-h study periods, there were fewer episodes and shorter duration of desaturation with oxygen compared with air and sham.

Conclusions At a flow rate of 0.1 l/min via nasal cannulae, air is no better than sham treatment in preventing desaturation in preterm infants, while 100% oxygen is superior to both.

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