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Specialist neonatal respiratory care for babies born preterm

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Quality statement 4: Oxygen saturation

Quality statement

Preterm babies have a target oxygen saturation of 91% to 95% after stabilisation.

Rationale

Maintaining an oxygen saturation level of between 91% and 95% can reduce mortality, particularly in babies born very preterm. A saturation level much lower than 91% increases the risk of mortality and morbidity.

Quality measures

Structure

Evidence of local arrangements and written clinical protocols to ensure that preterm babies have a target oxygen saturation of 91% to 95% after stabilisation.

Data source: Local data collection, for example, audits of oxygen administration protocols.

Process

Proportion of preterm babies who have a target oxygen saturation between 91% and 95% after stabilisation.

Numerator – the number in the denominator who have a target oxygen saturation between 91% and 95%.

Denominator – the number of preterm babies after stabilisation.

Data source: Local data collection, for example, audits of patient records.

Outcome

Mortality rates in preterm babies.

Data source: Local data collection, for example, audits of neonatal mortality rates. The National Neonatal Audit Programme (NNAP) collects data on mortality in preterm babies, which will be published according to local neonatal network from 2020.

What the quality statement means for different audiences

Service providers (such as neonatal units, including special care units, local neonatal units and neonatal intensive care units) ensure that systems are in place for preterm babies to have a target saturation level of 91% to 95%. They ensure that healthcare professionals are aware of this target.

Healthcare professionals (such as specialist neonatal nurses, specialist neonatal consultants and other paediatric specialists working with babies born preterm) ensure that oxygen saturation targets for preterm babies are between 91% and 95%. They monitor this using continuous pulse oximetry, supplemented by arterial sampling if clinically indicated.

Commissioners (such as clinical commissioning groups and NHS England) ensure that they commission services that specify target oxygen saturation levels of 91% to 95% in preterm babies.

Preterm babies have the amount of oxygen in their blood (oxygen saturation) monitored and kept at a safe level (between 91% and 95%).

Source guidance

Specialist neonatal respiratory care in babies born preterm (2019) NICE guideline NG124, recommendation 1.4.2

Definitions of terms used in this quality statement

Stabilisation

Facilitating and supporting a smooth transition from fetal to neonatal life. The process involves careful assessment of heart rate, colour (oxygenation) and breathing, with provision of appropriate interventions where indicated. [NICE's guideline on specialist neonatal respiratory care in babies born preterm, terms used in this guideline section.]