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Editor—We are happy to make it clear that we have never suggested that hypoxia is “beneficial” to babies with chronic lung disease. Indeed in describing our own practice we said, quite specifically, that “babies who were at least 8 weeks old (and it should be remembered that all our babies were born more than 12 weeks early), and whose retinal vasculature was mature, received liberal oxygen supplementation.” We would, however, remind Dr Primhak that those babies in the recent STOP-ROP trial who were given enough supplemental oxygen to maintain a saturation of 96–99% (to see if this reduced the severity of the retinopathy they had already developed) developed significantly more pulmonary problems than those only given enough oxygen to maintain a saturation of 89–94%.1
The idea that oxygen is always a “good thing” dies hard. Iles and Edmunds2 showed that babies with a saturation below 90% in air at discharge were more likely to have a frightening colour change, apnoeic episode and/or sudden change in muscle tone during the subsequent three month study period, but they did not show that that this risk was reduced by giving oxygen. There is equally little objective evidence that offering sustained supplemental oxygen actually does reduce the incidence of troublesome pulmonary hypertension.
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