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

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.

Keywords

persistent pulmonary hypertension of newborn - oxygen targets - survey - practice variations

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