Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

Authors

Juliann M. Di Fiore, Division of Neonatology, Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University, Cleveland, OH. Electronic address: jmd3@case.edu.
Richard J. Martin, Division of Neonatology, Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University, Cleveland, OH.
Hong Li, Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH.
Nathan Morris, Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH.
Waldemar A. Carlo, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
Neil Finer, Department of Pediatrics, University of California, San Diego, CA.
Michele Walsh, Division of Neonatology, Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University, Cleveland, OH.

Document Type

Article

Publication Title

The Journal of pediatrics

Abstract

OBJECTIVE: To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial. STUDY DESIGN: Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5  minutes) were documented in 1054 infants of 24-27 weeks of gestation while receiving supplemental oxygen during the first 3 days of life. RESULTS: Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA. CONCLUSION: Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00233324.

First Page

49

Last Page

56.e1

DOI

10.1016/j.jpeds.2017.01.057

Publication Date

7-1-2017

Recommended Citation

Di Fiore, Juliann M.; Martin, Richard J.; Li, Hong; Morris, Nathan; Carlo, Waldemar A.; Finer, Neil; and Walsh, Michele, "Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort" (2017). Randomized Controlled Trial. 50.
https://scholar.bridgeporthospital.org/randomized_trial/50

Identifier

28279433 (pubmed); NIHMS857932 (mid); PMC5484739 (pmc); 10.1016/j.jpeds.2017.01.057 (doi); S0022-3476(17)30167-1 (pii)