Forthcoming Issue 3 A survey of the optimal oxygen saturation targets in premature infants in the neonatal intensive care units of three tertiary care hospitals in Tshwane, South Africa.

Main Article Content

J G Thomas
M Coetzee

Abstract

Background: An optimal saturation target for premature infants receiving supplemental oxygen, that aims to decrease morbidity and mortality, has been the aim of many studies worldwide. Recently, a saturation target of 91-95% was recommended by the NeOProM collaboration.


Objective: This research aims to identify current practice and health care worker knowledge regarding target oxygen saturation in preterm infants.


Methodology: This cross-sectional descriptive study was conducted in three tertiary hospital neonatal units in Tshwane, South Africa. A web-based survey was administered to staff caring for premature infants. To confirm the reliability of the survey, a snapshot was performed to assess actual practice in the neonatal units.


Results: A total of 192 responses from the three neonatal units were analysed for the web-based survey. Overall, 55.7% of respondents indicated that a written standard operating procedure (SOP) for targeting oxygen saturation was in place. However, data analysis revealed that 43 different saturation target ranges were reported, with 90-95% being the most common. Approximately three-quarters of respondents indicated that supplemental oxygen may have harmful effects. Knowledge-based questions assessing the benefits and risks of targeting lower saturations (85-89%) were answered poorly. Snapshot data analysis revealed that 70.5% of infants were receiving oxygen, of which 81.4% received blended-oxygen. The majority (60.5%) of these premature infants had saturations above 95%, with only 27.9% of infants' snapshot saturation falling within the recommended range (91-95%).


Conclusion: The large number of saturation target ranges demonstrated indicates that staff are not following an SOP for targeting oxygen saturation in premature infants. To ensure standardized care, we recommend that all three units ensure the availability of a written SOP and perform ongoing staff training.

Article Details

How to Cite
Forthcoming Issue 3: A survey of the optimal oxygen saturation targets in premature infants in the neonatal intensive care units of three tertiary care hospitals in Tshwane, South Africa. (2024). South African Journal of Child Health, 18(2), e1994. https://doi.org/10.7196/
Section
Research
Author Biography

J G Thomas, University of Pretoria

Dr Thomas completed his MMed in Paediatrics and his FCPaed. He is currently a fellow in paediatric cardiology.

How to Cite

Forthcoming Issue 3: A survey of the optimal oxygen saturation targets in premature infants in the neonatal intensive care units of three tertiary care hospitals in Tshwane, South Africa. (2024). South African Journal of Child Health, 18(2), e1994. https://doi.org/10.7196/

References

Patz A. Oxygen Administration to the Premature Infant. Am J Ophthalmol 1967;63(2):351-353. Available at https://doi.org/10.1016/0002-9394(67)91567-x

Stenson BJ. Oxygen Saturation Targets for Extremely Preterm Infants after the NeOProM Trials. Neonatology 2016;109(4):352-358. Available at https://doi.org/ 10.1159/000444913

The STOP-ROP multicentre study group. Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP), A Randomized, Controlled Trial. I: Primary Outcomes. Pediatrics 2000;105(2):295-310. Available at https://doi.org/10.1542/peds.105.2.295

Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. Oxygen-saturation targets and outcomes in extremely preterm infants. N Engl J Med 2003;349(10):959-967. Available at https://doi.org/10.1056/NEJMoa023080

Visser L, Singh R, Young M, Lewis H, McKerrow N. Guideline for the prevention, screening and treatment of retinopathy of prematurity (ROP). SAMJ 2013;103(2):116-125. Available at https://doi.org/10.7196/SAMJ.6305

Askie LM, Darlow BA, Davis PG, et al. Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants. Cochrane Database Syst Rev 2017;4(4). Available at https://doi.org/10.1002/14651858.CD011190.pub2

McDonald CF. Low-flow oxygen: How much is your patient really getting? Respirology 2014;19(4):469-470. Available at https://doi.org/10.1111/resp.12290

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