The Importance of Oxygen Control Reaffirmed: Experience of ROP Reduction at a Single Tertiary Care Center
To report the impact of the adoption of a low oxygen saturation policy on retinopathy of prematurity (ROP) incidence at a single tertiary care center.
ROP incidence, procedures for ROP, and neonatal outcome among very low birth weight infants were compared before and after the adoption of a low saturation policy, which took place in 2004. The Mann–Whitney test was performed to look for differences.
The incidence of severe ROP significantly decreased from 5.3% of live very low birth weight infants between 1999 and 2004 to 1% of live very low birth weight infants between 2005 and 2012 (P = .003). The use of laser therapy for severe ROP between the same periods significantly decreased from 6.4% of live very low birth weight infants between 1999 and 2004 to 0.6% of live very low birth weight infants between 2005 and 2012 (P = .002). There was also a significant reduction of death or bronchopulmonary dysplasia from 33.8% between 1999 and 2004 to 24.2% between 2005 and 2012 (P = .02).
Trained personnel and low and tailored oxygen saturation intervals for very low birth weight infants could play a pivotal role in reducing the incidence of severe ROP without increasing mortality.
[J Pediatr Ophthalmol Strabismus 2014;51(2):112–115.]
- 1.Chow LC, Wright KW, Sola ACSMC Oxygen Administration Study Group. Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants?Pediatrics. 2003; 111:339–345.
10.1542/peds.111.2.339Crossref, Google Scholar
- 2.York JR, Landers S, Kirby RS, Arbogast PG, Penn JS. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. J Perinatol. 2004; 24:82–87.
10.1038/sj.jp.7211040Crossref, Google Scholar
- 3.Anderson CG, Benitz WE, Madan A. Retinopathy of prematurity and pulse oximetry: a national survey of recent practices. J Perinatol. 2004; 24:164–168.
10.1038/sj.jp.7211067Crossref, Google Scholar
- 4.Sun SC. Relation of target SpO2 levels and clinical outcome in ELBW infants on supplemental oxygen. Pediatr Res. 2002; 51:350A. Google Scholar
- 5.Tin W, Milligan DWA, Pennefather P, Hey E. Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks gestation. Arch Dis Child Fetal Neonatal Ed. 2001; 84:F106–F110.
10.1136/fn.84.2.F106Crossref, Google Scholar
- 6.SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research NetworkCarlo WA, Finer NN, Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med. 2010; 362:1959–1969.
10.1056/NEJMoa0911781Crossref, Google Scholar
- 7.BOOST II United Kingdom Collaborative GroupBOOST II Australia Collaborative GroupBOOST II New Zealand Collaborative Group, Oxygen saturation and outcomes in preterm infants. N Engl J Med. 2013; 368:2094–2104.
10.1056/NEJMoa1302298Crossref, Google Scholar
- 8.Schmidt B, Whyte RK, Asztalos EB, Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants. JAMA. 2013; 309:2111–2120.
10.1001/jama.2013.5555. Crossref, Google Scholar
- 9.Askie LM, Brocklehurst P, Darlow BA, NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol. BMC Pediatrics. 2011; 11:6. Google Scholar
- 10.The Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity. Arch Ophthalmol. 1984; 102:1130–1134.
10.1001/archopht.1984.01040030908011Crossref, Google Scholar
- 11.Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001; 163:1723–1729.
10.1164/ajrccm.163.7.2011060Crossref, Google Scholar
- 12.Walsh MC, Yao Q, Gettner P, Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics. 2004; 114;1305–1311.
10.1542/peds.2004-0204Crossref, Google Scholar