Document Detail


Effect of decreasing target oxygen saturation on retinopathy of prematurity.
MedLine Citation:
PMID:  21035066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The authors of previous studies suggest that the oxygenation status of premature infants contributes to the development of retinopathy of prematurity (ROP). In this study we compared the incidence and severity of ROP before and after institution of a new neonatal intensive care unit oxygen protocol.
METHODS: A retrospective chart review was performed of all eligible inborn patients screened for ROP during the 2 years immediately before (Group 1) to and the 2 years after (Group 2) the initiation of a new oxygen protocol. In the new protocol, target oxygen saturation was adjusted from 90%-99% to 85%-93%. Treatment criteria adhered to Early Treatment for Retinopathy of Prematurity guidelines for the study's duration.
RESULTS: There were 387 infants in Group 1 and 386 infants in Group 2 (descriptive statistics adjusted for correlation due to multiple births). Mean birth weights (BWs) and gestational ages were 1,194 g and 29.2 weeks (ranges, 525-2,085 g; 23 2/7-39 6/7 weeks) for Group 1 and 1,139 g and 28.9 weeks (ranges, 520-2,500 g; 22 6/7-35 3/7 weeks) for Group 2 (p = 0.02/0.10). ROP developed in 32.7% of infants in Group 1 and 27.8% in Group 2 (p = 0.17). The incidence of ROP requiring treatment was 19.9% in Group 1 and 20.5% in Group 2 (p = 0.91). Subanalysis of infants with BW ≤ 1,000g (Group 1, n = 119; Group 2, n = 141) revealed ROP incidence of 75.1% versus 57.1%, respectively (p < 0.01); treatable disease occurred in 37.5% and 21.9% of affected infants (p = 0.19).
CONCLUSIONS: Lowering target oxygen saturation for inborn premature infants was associated with decreased incidence of ROP only in infants with BW ≤ 1,000 g. Severity of disease, including need for treatment, was similar in both groups.
Authors:
Paul S Tlucek; Karen E Corff; Brianna C Bright; Susan M Bedwell; Kris C Sekar; R Michael Siatkowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  14     ISSN:  1528-3933     ISO Abbreviation:  J AAPOS     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2011-02-17     Revised Date:  2011-07-11    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-11     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Affiliation:
The Children's Hospital of Oklahoma and Dean A. McGee Eye Institute, Oklahoma City, Oklahoma, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Incidence
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal / methods*,  statistics & numerical data*
Male
Organizational Policy
Oximetry
Oxygen Inhalation Therapy* / adverse effects,  methods,  statistics & numerical data
Retinopathy of Prematurity* / epidemiology,  etiology,  prevention & control
Retrospective Studies
Severity of Illness Index
Comments/Corrections
Comment In:
J AAPOS. 2011 Apr;15(2):217; author reply 217-8   [PMID:  21463959 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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