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Am J Perinatol 2017; 34(03): 276-282
DOI: 10.1055/s-0036-1586754
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Deepthi Alapati
1   Department of Pediatrics, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware
2   Nemours Lung Research Center, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware
3   Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Romal Jassar
1   Department of Pediatrics, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware
3   Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
,
Thomas H. Shaffer
1   Department of Pediatrics, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware
2   Nemours Lung Research Center, Nemours, Alfred I. duPont Hospital for Children, Wilmington, Delaware
3   Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania
4   Department of Physiology and Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

28 April 2016

05 July 2016

Publication Date:
04 August 2016 (online)

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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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