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The risk for hyperoxaemia after apnoea, bradycardia and hypoxaemia in preterm infants
  1. H A van Zanten1,
  2. R N G B Tan1,
  3. M Thio2,3,
  4. J M de Man-van Ginkel4,
  5. E W van Zwet5,
  6. E Lopriore1,
  7. A B te Pas1
  1. 1Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2University of Melbourne, Melbourne, Victoria, Australia
  3. 3Hospital Sant Joan de Deu, Barcelona, Spain
  4. 4Utrecht University, Utrecht, The Netherlands
  5. 5Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to H A van Zanten, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, J6-S, PO Box 9600, Leiden 2300 RC, The Netherlands; h.a.van_zanten{at}lumc.nl

Abstract

Objective To investigate the occurrence and duration of oxygen saturation (SpO2) ≥95%, after extra oxygen for apnoea, bradycardia, cyanosis (ABC), and the relation with the duration of bradycardia and/or SpO2 ≤80%.

Methods All preterm infants <32 weeks’ gestation supported with nasal continuous positive airway pressure (nCPAP) admitted to our centre were eligible for the study. We retrospectively identified all episodes of ABCs. In ABCs where oxygen supply was increased, duration and severity of bradycardia (<80 bpm), SpO2 ≤80%, SpO2 ≥95% and their correlation were investigated.

Results In 56 infants, 257 ABCs occurred where oxygen supply was increased. SpO2 ≥95% occurred after 79% (202/257) of the ABCs, duration of extra oxygen supply was longer in ABCs with SpO2 ≥95% than without SpO2 ≥95% (median (IQR) 20 (8–80) vs 2 (2–3) min; p<0.001)). The duration of SpO2 ≥95% was longer than bradycardia and SpO2 ≤80% (median (IQR) 13 (4–30) vs 1 (1–1) vs 2 (1–2) min; p<0.001). SpO2 ≥95% lasted longer when infants were in ambient air than when oxygen was given before the ABC occurred (median (IQR)15 (5–38) min vs 6 (3–24) min; p<0.01).

Conclusions In preterm infants supported with nCPAP in the neonatal intensive care unit (NICU), SpO2 ≥95% frequently occurred when oxygen was increased for ABCs and lasted longer than the bradycardia and SpO2 ≤80%.

  • Neonatology
  • Nursing Care
  • hyperoxemia
  • supplemental oxygen
  • apnea

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