Management of Supplemental Oxygen for Infants with Persistent Pulmonary Hypertension of Newborn: A Survey

Am J Perinatol. 2017 Feb;34(3):276-282. doi: 10.1055/s-0036-1586754. Epub 2016 Aug 4.

Abstract

Objective To evaluate practice variations amongst neonatologists regarding oxygen management in neonates with persistent pulmonary hypertension of newborn (PPHN). Study Design An online survey was administered to neonatologists to assess goal oxygenation targets and oxygen titration practices in PPHN. Response variations were assessed and intergroup comparisons performed. Results Thirty-three percent (492) of neonatologists completed the survey. Twenty-eight percent reported using specific oxygen titration guidelines. Majority of respondents used a combination of oxygen saturation (SpO2) and arterial oxygen tension (PaO2) initially to titrate oxygen. Seventy percent of the respondents used higher goal SpO2 > 95% or 95 to 98% and thirty-eight percent of the respondents used PaO2 > 80 mm Hg. Physicians with extracorporeal membrane oxygenation experience and those with greater than ten years neonatal intensive care unit experience inclined toward use of SpO2 alone for oxygen titration and aimed for lower range of SpO2 and PaO2 targets. Greater proportion of neonatologists who employed specific oxygen titration guidelines used lower SpO2 targets. Conclusion Wide practice variations exist amongst neonatologists regarding optimal SpO2 and PaO2 targets and oxygen titration practices in the management of PPHN.

MeSH terms

  • Clinical Competence
  • Clinical Protocols
  • Cross-Sectional Studies
  • Humans
  • Infant, Newborn
  • Intensive Care, Neonatal
  • Neonatology / methods*
  • Oxygen / administration & dosage*
  • Oxygen / blood*
  • Oxygen Inhalation Therapy*
  • Partial Pressure
  • Persistent Fetal Circulation Syndrome / therapy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Prospective Studies
  • Surveys and Questionnaires

Substances

  • Oxygen