Pulse oximeter saturation target limits for preterm infants: a survey among European neonatal intensive care units

The optimum range of pulse oximeter oxygen saturation (SpO(2)) for preterm infants remains controversial. Between November 2015 and February 2016, we conducted a web-based survey aimed to investigate the current and former practices on SpO(2) targets in European neonatal intensive care units (NICUs). We obtained valid responses from 193 NICUs, treating 8590 newborns ≤28 weeks per year, across 27 countries. Forty different saturation ranges were reported, ranging from 82–93 to 94–99%. The most frequently utilized SpO(2) ranges were 90–95% (28%), 88–95% (12%), 90–94% (5%), and 91–95% (5%). A total of 156 NICUs (81%) changed their SpO(2) limits over the last 10 years. The most frequently reported former limits were 88–92% (18%), 85–95% (9%), 88–93 (7%), and 85–92% (6%). The NICUs that increased their SpO(2) ranges expected to obtain a reduction in mortality. A 54% of the NICUs found the scientific evidence supporting their SpO(2) targeting policy strong or very strong. Conclusion: We detected a high degree of heterogeneity in pulse oximeter SpO(2) target limits across European NICUs. The currently used limits are 3 to 5% higher than the former limits, and the most extreme limits, such as lower below 85% or upper above 96%, have almost been abandoned.