To view the original video and read the News Release, please go to http://www.nichd.nih.gov/news/releases/Pages/051610-preterm-survival.aspx
Dr. Rosemary HigginsProgram Scientist, Neonatal Research Network
"Higher Oxygen Levels Improve Preterm Survival, Increase Risk for Eye ConditionCPAP as Effective For Preemies as Ventilator,With Fewer Complications"
Eunice Kennedy ShriverNational Institute of ChildHealth and Human Development
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Why did you undertake the study?
Dr. Rosemary Higgins on camera
Dr. Rosemary Higgins: Babies born 13 to 16 weeks early often have trouble breathing on their own because their lungs are not fully developed. So it's common practice to give them oxygen to help them breathe. There isn't a lot of research to determine exactly how much oxygen they should get, or the best method to provide it to them. We know that if a baby's blood oxygen levels are too low, they can develop brain or other organ damage, or even die. On the other hand, we know that some babies given 100 percent oxygen are at high risk for a condition known as retinopathy of prematurity. Retinopathy of prematurity can cause vision impairment or blindness. So, lower oxygen levels might help prevent retinopathy of prematurity.
Dr. Higgins on camera
Dr. Higgins: Over the past 30-40 years, many hospitals have started using a newer technique for delivering oxygen to preemies. Traditionally, preterm infants are given oxygen through a ventilator. The ventilator tube is placed into the infant's wind pipe and pulses air into the lungs. The ventilator tube can also be used to administer surfactant into the lungs. That's a sticky substance that helps to keep the tiny air sacs open. In recent years, some hospitals have supplied oxygen through a CPAP device. CPAP, or C-P-A-P, stands for continuous positive airway pressure. It's used to treat adults with sleep apnea. With CPAP, a fitting is placed into the baby's nostrils, and gently pumps air into the lungs. It's usually used without surfactant. CPAP has not been directly compared to surfactant prior to the current study.
How did you conduct the study?
Dr. Higgins: Researchers in the NICHD Neonatal Research Network observed more than 1,300 infants born at 20 sites. These infants were very premature—born between the 24th and 27th week of pregnancy. They weighed only one to two pounds on average, and many needed respiratory therapy. For one arm of the study, we compared two different oxygen saturation targets: 85-89 percent versus 91-95 percent. The other part of the study compared the methods used to provide oxygen to the infants: ventilator with surfactant or the CPAP device.
What did your studies find?
Dr. Higgins: The first study found that the different oxygen levels had different effects on survival and retinopathy …