Premature Neonate Oxygen Targets — FRCA Final MCQ

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HardPaediatric AnaesthesiaPremature Neonate Oxygen TargetsFRCA Final

A neonate born at 30 weeks gestation, now 2 days old, requires laser treatment for retinopathy of prematurity. Regarding oxygen management during anaesthesia, what SpO2 target should be maintained?

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Correct answer: B — 88-95%

In premature neonates, oxygen must be carefully titrated to avoid both hypoxia and hyperoxia. SpO2 targets of 88-95% (or 90-95% depending on local guidelines) are recommended. Hyperoxia (SpO2 >95%) worsens retinopathy of prematurity (ROP) through retinal vascular damage from oxygen free radicals, while severe hypoxia (SpO2 <85%) causes neurological injury. The BOOST-II and NeOProM trials provided evidence for these targets. Air-oxygen blending with continuous SpO2 monitoring and alarm limits set appropriately is essential.

Reference: RCPCH – 2019 – Oxygen therapy in neonates; APA – 2019 – Neonatal anaesthesia guidelines