Abstract
Oxygenation instability is a very common problem in the premature infant that manifests
as intermittent hypoxemia episodes (HEs). These are particularly frequent in premature
infants who are on mechanical ventilation beyond the first weeks after birth. However,
they can also occur in spontaneously breathing infants. Some of these episodes are
due to central apnea, but in ventilated infants, they are frequently due to contractions
of the abdominal musculature that can splint the respiratory pump, resulting in periods
of decreased lung volume and hypoventilation. HEs are often followed by periods of
hyperoxemia that results from excessive oxygen supplementation given to correct the
hypoxemia. These episodes increase in frequency with postnatal age and are more common
in infants with chronic lung disease. Although the evidence is not conclusive, their
detrimental effects on the infant's neurologic, ocular, and respiratory system may
be significant. There is no specific treatment for HEs, but several interventions
are available to ameliorate the severity and duration of the episodes. Further research
is needed to define the impact of HEs on the preterm infant's developing central nervous
system and other organ systems and to develop effective strategies to prevent these
episodes.
Keywords
premature infants - episodes of hypoxemia - intermittent hypoxemia - hyperoxemia -
supplemental oxygen
