Oxygen Saturation Levels for all Preterm Infants Receiving Supplemental Oxygen

Publication: 05/01/2005  
Next review: 29/06/2024  
Clinical Protocol
ID: 555 
Approved By:  
Copyright© Leeds Teaching Hospitals NHS Trust 2018  


This Clinical Protocol is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Oxygen Saturation Levels for all Preterm Infants Receiving Supplemental Oxygen

All infants in oxygen: Target SaO2 91-94% (alarms 90-95%)


  • In infants < 32 weeks corrected gestation, hyperoxia should be avoided in order to reduce the risk of ROP1.

  • For preterm infants who are >32 weeks corrected gestation there is no evidence that higher oxygen saturation targets improve outcome and may increase respiratory morbidity3.

  • At high saturations SaO2 does not accurately reflect PaO2. SpO2 . If in doubt measure arterial PaO2. The target range for PaO2 is 6 -10 KPa 4,5.

  • Oxygen saturations will be affected by haemoglobin level, hypothermia, acidosis and poor skin perfusion. If in doubt monitor arterial PAO2.

  • Higher oxygen saturation targets may be prescribed on an individual patient basis only after consultant discussion.

  • In term infants with respiratory failure, higher oxygen saturation targets may be acceptable but hyperoxia should still be avoided.

  • All pulse oximeters have an inaccuracy of 2-3% so trend is more important than actual values.


Record: 555
Clinical condition:

Infants receiving supplemental oxygen

Target patient group: Neonates
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Adapted from:


Evidence base

  1. Flynn JT, Bancalari E. Snyder ES et al. A Cohort study of transcutaneous oxygen tension and the incidence and severity of retinopathy of prematurity. NEJM 1992;326:1050-4
  2. Askie LM, Henderson-Smart DJ, Irwig L et al. Oxygen Saturation targets and outcomes in extremely preterm infants. NEJM 2003;349:959-67
  3. The STOP-ROP Multicentre study group. Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity- a randomized controlled trial. Primary outcomes. Pediatrics 2000;105:295-310.
  4. American academy of paediatrics and American college of Obstetricians and Gynaecologists 1992.
  5. Guidelines for good practice in the management of neonatal respiratory distress syndrome. BAPM. 1998

Document history

LHP version 1.0

Related information

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