Control of breathing in preterm infants on incubator oxygen or nasal cannula oxygen

Abstract

Background: Incubator oxygen may improve respiratory stability in preterm infants compared with nasal cannula oxygen. Methods: Single center randomized trial of infants <29 weeks' gestation on supplemental oxygen at >= 32 weeks' postmenstrual age. Infants were crossed-over every 24 hours for 96 hours between incubator oxygen and nasal cannula <= 1.0 L/kg/min. We measured episodes of intermittent hypoxemia (oxygen saturations (SpO2) < 85% >= 10 seconds), bradycardia, cerebral and abdominal hypoxemia, and end-tidal carbon dioxide. Results: We enrolled 25 infants with a gestational age of 26 weeks 4 days +/- 15 days (mean +/- SD) and birth weight 805 +/- 202 grams. There were no differences in episodes of intermittent hypoxemia, bradycardia, or cerebral hypoxemia between groups. There were fewer episodes of abdominal hypoxemia <40% >= 10 seconds with incubator oxygen compared with nasal cannula (132 +/- 130 versus 158 +/- 125; p < 0.01). Time with SpO(2) < 85% and abdominal hypoxemia was lower among infants on incubator oxygen. Carbon dioxide values were higher while on incubator oxygen (41 +/- 11 versus 36 +/- 10 mmHg; p < 0.02). Conclusion: There was no difference in intermittent hypoxemia between incubator and nasal cannula oxygen among preterm infants on supplemental oxygen. Infants had higher levels of carbon dioxide while on incubator oxygen, which may have improved some measures of respiratory stability.