Analysis of risk factors for progression to treatment-requiring ROP in a single neonatal intensive care unit: is the exposure time relevant?

Giannantonio, Carmen; Papacci, Patrizia; Cota, Francesco; Vento, Giovanni; Tesfagabir, Mikael Ghennet; Purcaro, Velia; Lepore, Domenico; Molle, Fernando; Baldascino, Antonio; Romagnoli, Costantino

doi:10.3109/14767058.2011.587056

Cited by 40 publications

(37 citation statements)

References 31 publications

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“…Twenty-two out of 80 eyes (27.5%) presented with hemorrhage before treatment. A hemorrhage incidence of 22% was reported in the study by Pollack et al, which was comparable to our findings, but was much lower than the studies by Watts et al that described an incidence of 54.2% [5, 9, 16, 17]. A retrospective study suggested that both pre- and posttreatment hemorrhages (retinal or vitreous) were significantly associated with the progression to retinal detachment along with vitreous organization [5].…”

Section: Discussionsupporting

confidence: 87%

Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

Bai

Chen

et al. 2017

Journal of Ophthalmology

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Objective. To determine the prevalence and risk factors for the recurrence of retinopathy of prematurity (ROP) in Zone II Stage 3+ after ranibizumab treatment. Methods. This was a retrospective, nonrandomized, noncontrolled study that excluded Zone I and aggressive posterior ROP (APROP) cases. Infants who developed Zone II Stage 3 ROP with plus disease and underwent initial intravitreal injection of ranibizumab (IVR) were recruited. Patients were divided into 2 groups based on the outcome after initial ranibizumab treatment: recurrence of ROP or favorable outcome. Data was collected and analyzed by SPSS 16.0. Results. Forty-two patients were included, and 80 eyes with Zone II Stage 3+ were subjected to IVR treatment. Eleven of 42 patients (26.2%, 18 eyes) had a recurrence of ROP after the initial treatment. On univariate analysis, preretinal hemorrhage before treatment was significantly different between the two groups (P = 0.000). Multivariate analysis found that preretinal hemorrhage before treatment was the only factor associated with the recurrence of ROP in our study (P = 0.004). Conclusions. The recurrence rate of ROP in Zone II Stage 3+ after initial ranibizumab treatment was notable and preretinal hemorrhage before treatment was associated with the recurrence of ROP in our study.

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Section: Discussionsupporting

confidence: 87%

Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

Bai

Chen

et al. 2017

Journal of Ophthalmology

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“…Although the effect of oxygen release to tissue is not completely understood, this phenomenon possibly contributes to the pathogenesis of various illnesses of prematurity [2,3,4,5,6]. Normally, in full-term neonates, the fetal-to-adult hemoglobin switch occurs within a few months after birth, so that, for preterm infants, UCB-RBC units might represent the ideal RBC product.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, in prematurely born infants, this decline is significantly more rapid and pronounced [1]. Repeated RBC transfusions are acknowledged risk factors for retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD) [2,3,4,5,6]. Several approaches have been explored to prevent or even to reduce the threshold and the frequency of RBC transfusions.…”

Section: Introductionmentioning

confidence: 99%

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Bianchi¹,

Giannantonio

Spartano³

et al. 2014

Neonatology

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Background: Preterm infants often receive blood transfusions early in life. In this setting, umbilical cord blood (UCB) might be safer than adult blood (A) with respect to infectious and immunologic threats. Objectives: To evaluate, as a first objective, the feasibility of fulfilling transfusion needs of preterm infants with allogeneic UCB red blood cell (RBC) concentrates and, as a secondary objective, to assess the safety of allogeneic cord blood transfusions. Methods: At the Neonatal Intensive Care Unit and the UNICATT Cord Blood Bank of ‘A. Gemelli' Hospital in Rome, a prospective study was carried out over a 1-year period, enrolling newborns with gestational age ≤30 weeks and/or birth weight ≤1,500 g requiring RBC transfusions within the first 28 days of life. At first transfusion, patients were assigned to receive UCB-RBCs or A-RBCs depending on the availability of ABO-Rh(D)-matched UCB-RBC units. The same regimen (UCB-RBC or A-RBC units) was thereafter maintained, unless ABO-Rh(D)-matched UCB-RBC units were not available. Results: Overall, 23 UCB-RBC units were transfused to 9 patients; the requests for UCB-RBC units were met in 45% of patients at the first transfusion and in 78% at the subsequent transfusions. At a median follow-up of 57 days (range 6-219), no acute or delayed transfusion-related adverse events occurred. Hematocrit gain after transfusion and time intervals between transfusions were similar in the UCB-RBC and A-RBC group, as well. Conclusions: Transfusing allogeneic UCB-RBC units in preterm infants appears a feasible and safe approach, although the transfusion needs of our study population were not completely covered. More data are necessary to validate this novel transfusion practice. © 2014 S. Karger AG, Basel

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“…Several uniquely neonatal adverse associations have been demonstrated in epidemiological studies [29]. These include death [30], necrotising enterocolitis (NEC) [26,31], intraventricular haemorrhage (IVH) [32,33], retinopathy of prematurity (ROP) [34] and chronic lung disease (CLD) [35]. It is important to note however, that these observational studies using case control or retrospective cohort methodology report risk ratios for NEC following exposure to RBC transfusion that far exceed those demonstrated in randomised trials.…”

Section: Transfusion Safetymentioning

confidence: 99%

Anaemia in the Premature Infant and Red Blood Cell Transfusion: New Approaches to an Age-Old Problem

Andersen

Keir

Kirpalani

et al. 2015

Curr Treat Options Peds

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Opinion statementRed blood cell (RBC) transfusion is a common intervention in very preterm infants with variable utilisation between centres and individual clinicians. This variation likely reflects uncertainty about who, when and how much to transfuse. Most RBC transfusions are given in small volumes as "top-up" for anaemia or cumulative phlebotomy loss. Whilst the newly born infant may have a low haemoglobin (Hb) value, it is uncertain if this is of clinical or physiologic significance except at extreme values. Little attention has been given to the potentially favourable effect of RBC transfusion on oxygen kinetics, particularly in the interval after birth when the risk of hypoxic ischaemia is high. Later anaemia, at the time of likely Hb nadir, more typifies anaemia of prematurity. In this article, we will firstly review the conventional model of RBC transfusion based on haemoglobin [Hb] thresholds and secondly, we will propose an alternate, individualised, practice based on the oxygen physiology. This effectively reframes the potential role of RBC transfusion in the very preterm infant and demands a new generation of clinical trials.

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Analysis of risk factors for progression to treatment-requiring ROP in a single neonatal intensive care unit: is the exposure time relevant?

Abstract: Risk factors for ROP play their role since birth. Beside scrupulous oxygen-administration monitoring and prevention of infections, blood transfusions are of primary importance in the development of treatment-requiring ROP.

Cited by 40 publications

References 31 publications

Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

Recurrence of Retinopathy of Prematurity in Zone II Stage 3+ after Ranibizumab Treatment: A Retrospective Study

Allogeneic Umbilical Cord Blood Red Cell Concentrates: An Innovative Blood Product for Transfusion Therapy of Preterm Infants

Anaemia in the Premature Infant and Red Blood Cell Transfusion: New Approaches to an Age-Old Problem

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