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Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm.

Publication ,  Journal Article
Foglia, EE; Carper, B; Gantz, M; DeMauro, SB; Lakshminrusimha, S; Walsh, M; Schmidt, B ...
Published in: J Pediatr
June 2019

OBJECTIVE: To determine the impact of policy changes for pulse oximetry oxygen saturation (SpO2) alarm limits on neonatal mortality and morbidity among infants born very preterm. STUDY DESIGN: This was a retrospective cohort study of infants born very preterm in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants were classified based on treatment at a hospital with an SpO2 alarm policy change and study epoch (before vs after policy change). We used a generalized linear mixed model to determine the effect of hospital group and epoch on the primary outcomes of mortality and severe retinopathy of prematurity (ROP) and secondary outcomes of necrotizing enterocolitis, bronchopulmonary dysplasia, and any ROP. RESULTS: There were 3809 infants in 10 hospitals with an SpO2 alarm policy change and 3685 infants in 9 hospitals without a policy change. The nature of most policy changes was to narrow the SpO2 alarm settings. Mortality was lower in hospitals without a policy change (aOR 0.63; 95% CI 0.50-0.80) but did not differ between epochs in policy change hospitals. The odds of bronchopulmonary dysplasia were greater for hospitals with a policy change (aOR 1.65; 95% CI 1.36-2.00) but did not differ for hospitals without a policy change. Severe ROP and necrotizing enterocolitis did not differ between epochs for either group. The adjusted odds of any ROP were lower in recent years in both hospital groups. CONCLUSIONS: Changing SpO2 alarm policies was not associated with reduced mortality or increased severe ROP among infants born very preterm.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

June 2019

Volume

209

Start / End Page

17 / 22.e2

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Retrospective Studies
  • Retinopathy of Prematurity
  • Policy Making
  • Pediatrics
  • Oxygen Consumption
  • Oximetry
  • Morbidity
  • Male
  • Intensive Care Units, Neonatal
 

Citation

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Foglia, E. E., Carper, B., Gantz, M., DeMauro, S. B., Lakshminrusimha, S., Walsh, M., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2019). Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm. J Pediatr, 209, 17-22.e2. https://doi.org/10.1016/j.jpeds.2019.01.048
Foglia, Elizabeth E., Benjamin Carper, Marie Gantz, Sara B. DeMauro, Satyan Lakshminrusimha, Michele Walsh, Barbara Schmidt, and Barbara Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. “Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm.J Pediatr 209 (June 2019): 17-22.e2. https://doi.org/10.1016/j.jpeds.2019.01.048.
Foglia EE, Carper B, Gantz M, DeMauro SB, Lakshminrusimha S, Walsh M, et al. Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm. J Pediatr. 2019 Jun;209:17-22.e2.
Foglia, Elizabeth E., et al. “Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm.J Pediatr, vol. 209, June 2019, pp. 17-22.e2. Pubmed, doi:10.1016/j.jpeds.2019.01.048.
Foglia EE, Carper B, Gantz M, DeMauro SB, Lakshminrusimha S, Walsh M, Schmidt B, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm. J Pediatr. 2019 Jun;209:17-22.e2.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

June 2019

Volume

209

Start / End Page

17 / 22.e2

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Retrospective Studies
  • Retinopathy of Prematurity
  • Policy Making
  • Pediatrics
  • Oxygen Consumption
  • Oximetry
  • Morbidity
  • Male
  • Intensive Care Units, Neonatal