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Exploring the risk of hyperoxia in oxygen-dependent very low birthweight infants in the first week of life to plan future trials of oxygen targeting
  1. Rod Kelly1,2,
  2. David Quine2,
  3. Ben J Stenson2
  1. 1 Neonatal Transport, ScotSTAR Scottish Neonatal Transport Service, Paisley, UK
  2. 2 Department of Neonatology, NHS Lothian, Edinburgh, UK
  1. Correspondence to Dr Rod Kelly, Neonatology, NHS Lothian, Edinburgh EH1 3EG, Edinburgh, UK; rod.kelly{at}

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The practice of titrating supplemental oxygen to target levels of pulse oximeter saturation (SpO2) evolved with little supporting evidence. Before this, the recommended practice was to target transcutaneous or arterial PO2 to 6.7–10.7 kPa (50–80 mm Hg).1 2 Recent evidence shows that SpO2 targets below 90% increase mortality and necrotising enterocolitis and higher targets increase retinopathy of prematurity treatment, but not blindness or disability.3 4 The optimal SpO2 target range for preterm infants is unknown. Trials of higher SpO2 targets are needed to determine any further survival advantage to be gained. Because the haemoglobin oxygen dissociation curve flattens at higher SpO2, the likelihood of hyperoxia at higher SpO2 needs to be better understood before such trials are designed. We explored the relationship between arterial oxygen tension …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.