TYK384
You are working with an anesthesia fellow, caring for 3 week-old ex-28 week premature infant undergoing a laparotomy for suspected bowel perforation in the setting of NEC and probable sepsis. The infant is stable and ventilating well. Concerned about ROP, you adjust the oxygen level down from 100% FiO2, explaining to the fellow that:
a) The only safe level of FiO2 is 30% or below
b) Vitamin E administration in neonates has been shown to worsen ROP
c) The presence of sepsis increases the risk of ROP in this infant
d) The FiO2 should be titrated to keep the oxygen saturation at 96% or above
e) The need for a blood transfusion will not alter the risk of ROP in this infant
Answer
Answer c. Sepsis is a risk factor for developing ROP. Goal SpO2 in premature infants is usually 85-94% in order to decrease the sequelae of hyperoxia. However, FiO2 requirement may be above 30% in order to achieve this blood saturation.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.