In this section
Oxygen is toxic and, through free radical damage, contributes to eye and lung injury. Excessive oxygen is associated with higher rates of retinopathy of prematurity (ROP) whilst inadequate oxygenation is associated with an increase in mortality in preterm infants. Three large multi-centre randomised controlled trials have addressed the question of the most appropriate oxygen saturation targets to minimise the incidence of ROP without increasing other morbidities and mortality. Based on this evidence, oxygen saturations should be targeted within the range of 91-95% in both preterm and term neonates.
To provide medical and nursing staff at the Royal Children’s Hospital with clear parameters within which SpO2 levels should be maintained, in the neonate when they are receiving oxygen.
Preterm and term infants receiving oxygen therapy should have their SpO2 measured continuously by pulse oximetry. Link to Nursing Assessment Guideline.
Any infant who has a recorded SpO2 persistently outside the targeted range should have their oxygen therapy adjusted by nursing or medical staff to maintain SpO2 within the specified range.
If a significant increase in inspired oxygen (>10%) is required to maintain SpO2 then a medical review of that infant should be requested.
For these infants the targeted range may be altered. Any deviation from the above guideline will be at the discretion of the treating consultant and will be documented in the medical notes and an appropriate order created in the EMR.
Evidence table for this guideline can be viewed here.
Please remember to read the disclaimer.
The development of this clinical guideline was coordinated by Trudy
Holton, Clinical Nurse Educator, Butterfly Ward. Approved by the Clinical Effectiveness Committee. Authorised by Bernadette Twomey, Executive Director Nursing Services. First published May 2009, current as of June 2016.