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April 2015

Oxygen Therapy for Preterm Neonates: The Elusive Optimal Target

Author Affiliations
  • 1Division of Neonatology, British Columbia’s Women’s Hospital and Health Centre, Vancouver, British Columbia, Canada
  • 2Department of Pediatrics, The Hospital for Sick Children, and the University of Toronto, Toronto, Ontario, Canada
JAMA Pediatr. 2015;169(4):311-313. doi:10.1001/jamapediatrics.2014.3664

Oxygen is the most commonly used “drug” for preterm babies. Oxygen is essential for life. Yet, the too-liberal use of oxygen is toxic.1-4 The Surfactant, Positive Pressure, and Oxygenation Randomized Trial, the Benefits of Oxygen Saturation Targeting trials, and the Canadian Oxygen Trial (all randomized clinical controlled trials) sought to identify the optimal oxygen saturation target range in extremely preterm neonates (85%-89% vs 91%-95%). At the time that these trials were conducted, the American Academy of Pediatrics recommended using oxygen therapy to maintain peripheral oxygen saturations in the 85% to 95% range. Impressively, all 3 trial groups embarked on rigorously designed trials that would facilitate an eventual meta-analysis. Do we now have an optimal “dose” of oxygen for the preterm neonate?

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