Improving blood gas control in mechanically ventilated, premature infants through monitoring and evaluation of clinical practice

Mechanical ventilation causing hypocapnia or hyperoxia carries a risk for the pre-term infant. The aim was to improve blood gas control in our unit. A guideline was written, and all personnel were motivated concerning blood gas control. Case records of all mechanically ventilated premature infants were examined during two 3-month periods, before and after intervention. The hours spent with hypocapnia (pCO2 < 4 kPa) or hyperoxia (PO2 > 12 kPa) were recorded. Case records of 31 infants were examined for a total of 1358 h of mechanical ventilation, 641 h before and 717 h after the intervention. The percentage time of hypocapnia before intervention (7.0%) was reduced significantly (P = 0.044) to less than half (2.9%) after intervention. Hyperoxia was reduced from 14.5% to 8.7% (P = 0.072). Blood gas control of mechanically ventilated premature infants could be improved with little effort, but hyperoxia is too frequent.