Management of Supplemental Oxygen for Infants with Persistent Pulmonary Hypertension of Newborn: A Survey

Objective To evaluate practice variations amongst neonatologists regarding oxygen management in neonates with persistent pulmonary hypertension of newborn (PPHN). Study Design An online survey was administered to neonatologists to assess goal oxygenation targets and oxygen titration practices in PPHN. Response variations were assessed and intergroup comparisons performed. Results Thirty-three percent (492) of neonatologists completed the survey. Twenty-eight percent reported using specific oxygen titration guidelines. Majority of respondents used a combination of oxygen saturation (SpO(2)) and arterial oxygen tension (PaO2) initially to titrate oxygen. Seventy percent of the respondents used higher goal SpO(2) > 95% or 95 to 98% and thirty-eight percent of the respondents used PaO2 > 80 mm Hg. Physicians with extracorporeal membrane oxygenation experience and those with greater than ten years neonatal intensive care unit experience inclined toward use of SpO(2) alone for oxygen titration and aimed for lower range of SpO(2) and PaO2 targets. Greater proportion of neonatologists who employed specific oxygen titration guidelines used lower SpO(2) targets. Conclusion Wide practice variations exist amongst neonatologists regarding optimal SpO(2) and PaO2 targets and oxygen titration practices in the management of PPHN.