Oxygen Saturation Targets

• At risk babies should have an overnight saturation run prior to discharge.
• Infants who do not maintain these saturation parameters while breathing air but are otherwise ready for discharge should be considered for home oxygen.

Following Discharge Home

• Minimum oxygen flow rate at home is 0.125L/min.
• No changes in oxygen administration should be made for the first two weeks.
• After two weeks, a 12-hour baseline overnight oximetry recording is done.
• Weaning can be commenced, when oxygen saturation ≥90% for 90% of the time.
• The overall mean SaO₂ should be ≥92%

Weaning off Oxygen

• A Home Care nurse will visit during the baby’s first time off oxygen.
• Weaning off oxygen will start during the daytime.
• Initially the baby should have up to 4 hours off oxygen, increasing to 6 - 8 hours, then 8 - 12 hours and finally off oxygen at night as well.
• A Home Care nurse will phone the day after each change in oxygen administration, to review progress.
• 2-3 days after each change, a Home Care nurse will visit and check oxygen saturations for a 40 minute period. The baby should be off oxygen for at least 1-2 hours prior to this check.
• If the baby remains stable and well, overnight 12 hour pulse oximetry is checked again a minimum of 2 weeks later with the view to continue weaning.
• Oximetry reports will be reviewed with a neonatal specialist and recommendations implemented the same or the following day.
• A 12-hour overnight oximetry recording should be done the day the baby discontinues oxygen therapy.
• Once oxygen is discontinued, a telephone call should be made the following day to check on progress and then an overnight 12-hour oximetry recording should be made one week later.

References