Management of oxygen saturation monitoring in preterm newborns in the NICU: the Italian picture.

Background: Although many studies emphasize the importance of using oxygen saturation (SpO ₂ ) targets in the NICUs, there is a wide variability in used saturation ranges among centers. Primary aim was to draw a representative picture on how the management of oxygen monitoring is performed in the Italian NICUs. Second aim was to identify healthcare-professionals related factors associated with oxygen targeting in the preterm population.
Methods: Cross-sectional study with data collection via an electronic survey form. A questionnaire containing pre-piloted and open questions on monitoring and management of the SpO ₂ was administered to neonatologists across the network of the Italian Society of Neonatology. The questions focused on: the infrastructure, specific training, healthcare professionals and patients-related factors. The results of the survey were anonymously collected, summarized and analyzed.
Results: Out of 378 questionnaires, 93 were correctly filled. Thirty-six different SpO ₂ ranges were observed. Centers using written standard operating procedures on oxygen management and SpO ₂ monitoring maintained a correct average range of SpO ₂ 90-95%, avoided hyperoxia and reconsidered saturation targets in relation to comorbidities. 39.8% of responders disabled alarms during neonatal care. One center used biomarkers for complete monitoring of neonatal oxygenation status.
Conclusions: There is considerable variation in SpO ₂ targets for preterm infants in the Italian NICUs. Standard operating procedures and specific training for health care personnel are the main factors playing a role for the correct maintenance of the recommended oxygen targets in preterms.