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.