Oxygen saturation targeting by pulse oximetry in the extremely low gestational age neonate: A quixotic quest

James J. Cummings, Satyan Lakshminrusimha

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Purpose of review A collaboration of comparative effectiveness research trials of pulse oximeter saturation (SpO 2) targeting in extremely low-gestational-Age neonates have begun to report their aggregate results. We examine the results of those trials, collectively referred to as the Neonatal Oxygenation Prospective Meta-Analysis or NeOProM. We also discuss the uncertainties that remain and the clinical challenges that lie ahead. Recent findings The primary outcome from NeOProM was a composite of death or disability at 18-24 months corrected age. In 2016 the last of these reports was published. Although there were no differences in the primary outcome overall, analyses of secondary outcomes and data subsets following a pulse oximeter revision show significant treatment differences between targeting a lower compared with a higher SpO 2. Summary NeOProM represents the largest collaborative clinical research study of SpO 2 targets in extremely low-gestational-Age neonates. Although aggregate results give us some insight into the feasibility and efficacy of SpO 2 targeting in this population, many questions remain. A patient-level analysis, tracking individual outcomes based on actual SpO 2 experienced, may shed some light on these questions. However, finding a single optimal SpO 2 range seems unlikely.

Original languageEnglish (US)
Pages (from-to)153-158
Number of pages6
JournalCurrent Opinion in Pediatrics
Issue number2
StatePublished - Apr 1 2017


  • comparative effectiveness research
  • extremely low gestational age neonates
  • Neonatal Oxygenation Prospective Meta-Analysis
  • oxygen saturation
  • pulse oximetry

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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