PubMed · 7418430
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K G Belani, I J Gilmour. 1980. Maximum inspiratory force.. https://pubmed.ncbi.nlm.nih.gov/7418430/
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OBJECTIVES: We studied 22 neonates with gestational ages from 26 to 40 weeks to determine how accurately pulse oxygen saturation (SpO2) could predict arterial partial pressure of oxygen (PaO2) and how much time and effort would be required to achieve and maintain a desired SpO2 value. STUDY DESIGN: SpO2 was maintained at 90%, 92%, 94%, 96%, and 98% by adjustment of FiO2. PaO2 was correlated with SpO2 by nonlinear mixed effects regression analysis. RESULTS: PaO2(y) correlated positively with SpO2(x): y = (0.03). e0.08(x). Variation of PaO2 increased from a range of +/- 10 Torr at SpO2 = 90% to +/- 28 Torr at SpO2 = 98%, principally as a result of decreasing hemoglobin-oxygen affinity, with no effect of advancing gestational age, subject temperature, pH, PaCO2. Considerable time (18 +/- 14 SD minutes) and effort (5 +/- 3 SD FiO2 adjustments/min were required to achieve and maintain a desired SpO2. CONCLUSIONS: PaO2 varied broadly with SpO2 in a clinically acceptable range of SpO2 (90% to 98%), and the variability increased at higher SpO2 values. Considerable time and effort were required to achieve and maintain desired SpO2 values.
OBJECTIVE: To study the effect of increased survival of infants <29 weeks' gestation on the incidence and severity of retinopathy of prematurity (ROP). METHODOLOGY: Review of prospective records from 1986 to 1992 kept in the New South Wales (NSW) NICUS database on infants admitted to the neonatal intensive care units (NICU) in NSW. The survival rate and the incidence and severity of ROP on all infants <29 weeks' gestation admitted to the NICUs in NSW from 1 July 1986 to 31 December 1987 were compared to a similar group of infants admitted from 1 January 1992 to 31 December 1992. RESULTS: There was a significant difference in the survival rate of infants admitted between the two periods (235 of 376, 62.5% survival vs 255 of 336, 75.9% survival, respectively, P<0.0001). The odds ratio for survival adjusted for gestational age in the second period was 1.76 [1.24, 2.48 (95% confidence interval), P<0.002]. There was a slight increase in ROP in the second period (79 of 172 examined, 45.9% ROP vs 133 of 238 examined, 55.8% ROP, respectively). There was a rise in the number of infants with Stage 3 ROP in the second time period (14 of 172 examined, 8.1% ROP vs 41 of 238 examined, 17.2% ROP, respectively). However, fewer infants had detached retinas or > or = Stage 4 ROP in the second group [7 of 172, (4.1 %) vs 3 of 238, (1.3%), respectively]. This may be a reflection of the increase in the use of cryo- or laser therapy for Stage 3 ROP with 'plus' disease [2 of 172 examined, (1.2%) vs 18 of 238 examined, (7.6%), respectively]. CONCLUSIONS: With the increase in survival of the very preterm infant in recent years, there has been an increase in severe ROP (> or = Stage 3) in NSW. Despite the increased survival of the highest at-risk group (24- to 26-week gestation infants), there have been fewer cases of retinal detachment. There was also a rise in the number of infants receiving cryo- or laser therapy intervention.
The aim of this study of consecutive livebirths between 23 and 30 weeks of gestational age was to determine the changes over time in the relationship between gestational age and the consumption of nursery resources by surviving preterm infants. Three discrete eras, comprising the years 1977-1985, 1986-1990, and 1991-1995, were identified, based on availability of ventilators and changes in perinatal care. The survival rate rose dramatically with each week's increase in gestational age, and increased significantly between successive eras. Overall, consumption of resources for assisted ventilation by survivors increased over time. In infants born before 28 weeks, for each week of decrease in gestational age, survivors averaged an extra 12.9 days of assisted ventilation in 1977-1985, 13.4 days in 1986-1990, and 13.5 days in 1991-1995, while infants born between 28-30 weeks of gestational age needed only an extra 2.3 days, 3.3 days, and 4.6 days of assisted ventilation for each week of decrease in gestational age in successive eras, respectively. There was no indication that improvements in perinatal care over time shortened the duration of assisted ventilation for surviving preterm infants.