Evidence map›Paper›PMID 39183262›Full record

ArticleBMC nursing2024

Oxygen delivery and monitoring in neonatal intensive care units in Mexico in 2011 and in 2023: an observational longitudinal study.

Luz Consuelo Zepeda Romero, Daniel Perez Rulfo Ibarra, Juan Carlos Barrera De Leon, Valeria Alejandra Salas Cruz, David Blanco Bouzo, Jose Alfonso Gutierrez Padilla, Clare Gilbert

Abstract read
In one paragraph

Article in BMC nursing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Luz Consuelo Zepeda RomeroNeonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico. drconsuelo@yahoo.com.
Daniel Perez Rulfo IbarraDepartamento de Reproduccion Humana, Crecimiento y Desarrollo, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico.
Juan Carlos Barrera De LeonDepartamento de Pediatría, Hospital Materno Infantil Esperanza Lopez Mateos, Secretaria de Salud Jaisco, Zapopan, Jalisco, Mexico.
Valeria Alejandra Salas CruzNeonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico.
David Blanco BouzoNeonatal Ophtalmology, Pediatric Surgery, Hospital Civil de Guadalajara, University Center of Health Sciences, University of Guadalajara, Zapopan, Jalisco, Mexico.
Jose Alfonso Gutierrez PadillaDivisión de Discipinas Clínicas, Centro Universitario de Ciencias de la Salud, Universidad De Guadalajara, Zapopan, Jalisco, Mexico.
Clare GilbertDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRetinopathy of prematurity (ROP) is a leading cause of avoidable blindness in children, particularly in Latin America, where hyperoxia is a significant risk factor. This study evaluated resource availability and use for administering and monitoring supplemental oxygen in Mexico.

methodsIn 2011, an observational study in which 32 government neonatal intensive care units (NICUs) across Mexico were visited. Data collected included occupancy, staffing levels, and equipment to deliver and monitor supplemental oxygen. Preterm infants receiving oxygen were observed. In 2023, 13 NICUs were revisited, and similar data collected. Staffing levels were benchmarked against Argentinian and US recommendations.

resultsIn 2011, only 38% of NICUs had adequate medical and staffing levels to meet recommended cot-to-staff ratios for all shifts. Staffing ratios were worse during weekends and at night than during weekdays. Only 25.5% of cots had blenders, and 80.1% had saturation monitors. 153 infants were observed 87% of whom were being monitored. Upper and lower oxygen saturations were ≥ 96% in 53%, and ≤ 89% in 8%, respectively. Alarm settings were inadequate, as 38% and 32% of upper and lower alarms were switched off and 16% and 53% were incorrectly set, respectively. In the 13 NICUs with data from 2011  and 2023, cot-to-staff ratios deteriorated over time, and in 2023 no unit had recommended ratios for all shifts. Equipment provision did not change, with similar proportions of babies in oxygen being monitored (79% 2011; 75% 2023). Rates of hyperoxia decreased slightly from 54% in 2011 to 49% in 2023. More upper alarms were set (46% 2011; 75% 2023), but a higher proportion were incorrectly set (52% 2011; 68% 2023).

conclusionsBetween 2011 and 2023, cot-to-staff ratios worsened, and equipment for safe oxygen delivery and monitoring remained insufficient. Despite available monitoring equipment, oxygen saturations often exceeded recommended levels, and alarms were frequently not set or incorrectly configured. Urgent improvements are needed in healthcare workforce numbers and practices, along with ensuring adequate equipment for safe oxygen delivery.

Indexed as

MexicoNeonatal intensive care unitsOxygen deliveryOxygen monitoringPublic healthRetinopathy of prematurityRisk factors

Identifiers

PMID39183262
PMCPMC11346044

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.