Abstract
<h3>Background and aims</h3> The optimal target range for pulse oximeter saturation (SpO<sub>2</sub>) in extremely preterm infants is unknown. BOOST-II UK is one of 5 international studies that have recently investigated this. <h3>Methods</h3> Preterm infants born before 28 weeks’ gestation were randomised within 24 h of birth to an SpO<sub>2</sub> target range of 85–89% or 91–95%. The intervention used masked offset oximeters and was continued until 36 weeks’ gestation. The primary outcome was a composite of death or serious neurosensory disability (SND) in survivors at age 2 corrected for prematurity, evaluated in 745 infants cared for using updated trial oximeters. A sensitivity analysis restricted to infants assessed by a Bayley III examination and a secondary analysis including a further 228 infants who were studied before the oximeters were updated were also performed. <h3>Results</h3> The primary outcome was determined for 722 (96.9%) of infants. The sensitivity analysis showed similar results. In the secondary analysis the mortality difference was 4.9% (p = 0.05). Severe visual loss did not differ between groups. <h3>Conclusions</h3> The higher SpO<sub>2</sub> target group had 8.5% greater survival with no increase in serious neurosensory disability. For infants born before 28 weeks’’ gestation, SpO<sub>2 </sub>targets below 90% are not recommended.
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