Abstract
Some of the complications associated with extreme immaturity are potentiated by an excess of free radicals. However, hypoxemia may also cause adverse outcomes. Oxygen saturation targeting starting at birth in preterm infants has been based on observational data and expert opinion. Data from the five randomized controlled trials included a total of 4965 extremely preterm infants less than 28 weeks’ gestation. The meta-analysis of these trials shows an increased risk of mortality and necrotizing enterocolitis and a decreased risk of retinopathy of prematurity with targeting oxygen saturation ranges of 85% to 89% compared with targeting of 91% to 95%. There was no difference in blindness or neurodevelopmental outcomes at 18 to 24 months follow-up. Many updated guidelines now recommend targeting oxygen saturation levels as measured by pulse oximetry similar to the range of oxygen saturation found to reduce mortality in these trials (91%–95%).
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