Email updates

Keep up to date with the latest news and content from BMC Pediatrics and BioMed Central.

Open Access Research article

Adherence to oxygenation and ventilation targets in mechanically ventilated premature and sick newborns: a retrospective study

Marianne Trygg Solberg12*, Ida Torunn Bjørk2 and Thor Willy R Hansen34

Author Affiliations

1 Lovisenberg Deaconal University College, Oslo, Norway

2 Department of Nursing Science, Faculty of Medicine, University of Oslo, Nedre Ullevål 9, Stjerneblokka 0850 Oslo, Norway

3 Department of Neonatal Intensive Care, Women’s and Children’s Division, Oslo University Hospital, Oslo, Norway

4 Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

For all author emails, please log on.

BMC Pediatrics 2013, 13:126  doi:10.1186/1471-2431-13-126

Published: 19 August 2013

Abstract

Background

Ventilator treatment exposes newborns to both hyperoxemia and hyperventilation. It is not known how common hyperoxemia and hyperventilation are in neonatal intensive care units in Norway. The purpose of this study was to assess the quality of current care by studying deviations from the target range of charted oxygenation and ventilation parameters in newborns receiving mechanical ventilation.

Methods

Single centre, retrospective chart review that focused on oxygen and ventilator treatment practices.

Results

The bedside intensive care charts of 138 newborns reflected 4978 hours of ventilator time. Arterial blood gases were charted in 1170 samples. In oxygen-supplemented newborns, high arterial pressure of oxygen (PaO2) values were observed in 87/609 (14%) samples. In extremely premature newborns only 5% of the recorded PaO2 values were high. Low arterial pressure of CO2 (PaCO2) values were recorded in 187/1170 (16%) samples, and 64 (34%) of these were < 4 kPa. Half of all low values were measured in extremely premature newborns. Tidal volumes above the target range were noted in 22% of premature and 20% of full-term newborns.

Conclusions

There was a low prevalence of high PaO2 values in premature newborns, which increased significantly with gestational age (GA). The prevalence of low PaCO2 values was highest among extremely premature newborns and decreased with increasing GA. Further studies are needed to identify whether adherence to oxygenation and ventilation targets can be improved by clearer communication and allocation of responsibilities between nurses and physicians.

Keywords:
Newborn infant; Premature infant; Mechanical ventilation; Oxygenation