Effect of decreasing target oxygen saturation on retinopathy of prematurity

Tlucek, Paul S.; Corff, Karen E.; Bright, Brianna C.; Bedwell, Susan; Sekar, Krishnamurthy; Siatkowski, R. Michael

doi:10.1016/j.jaapos.2010.06.013

Cited by 16 publications

(22 citation statements)

References 29 publications

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“…1 Our findings are, of course, independent of other studies. At the time of publication, the Surfactant, Positive Pressure, and Oxygenation Randomized Trial (ie, SUPPORT) study was the only prospective, randomized study examining the relationship between lower oxygen saturation targets and the incidence and severity of ROP.…”

Section: Replysupporting

confidence: 79%

“…To the Editor: In "Effect of Decreasing Target Oxygen Saturation on Retinopathy of Prematurity," Tlucek and colleagues 1 show that after a change in oxygen saturation protocol from 90%-99% to 85%-93%, there was a decrease in the incidence of retinopathy of prematurity (ROP) only in infants #1,000g. Interestingly, there was not a statistically significant difference in need for treatment or severity of disease between the 2 groups.…”

mentioning

confidence: 99%

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Effect of Decreasing Target Oxygen Saturation on Retinopathy of Prematurity

Leenheer¹,

Wright²,

Lee

2011

Journal of American Association for Pediatric Ophthalmology and

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Section: Replysupporting

confidence: 79%

mentioning

confidence: 99%

Effect of Decreasing Target Oxygen Saturation on Retinopathy of Prematurity

Leenheer¹,

Wright²,

Lee

2011

Journal of American Association for Pediatric Ophthalmology and

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“…27 Another theory is that there could be an increase in free radicals after the transfusions due to an increase in plasma free iron. [28][29][30] Logistic regression takes into account the relative contributions of various factors and makes it clear that the true risk factor is low gestational age and the consequential immaturity of the premature infant's various tissues. In other words, the true risk factor is prematurity and the other factors (low SNAPPE II score at birth, bronchopulmonary dysplasia, use of oxygen in mechanical ventilation, use of diuretics and the necessity for blood transfusions) are just consequences of this prematurity and are driven towards the same statistical significance observed in isolated tests.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for retinopathy of prematurity in a Brazilian reference service

et al. 2014

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CONTEXT AND OBJECTIVE: Retinopathy of prematurity (ROP) is a known cause of blindness in which diagnosis and timely treatment can prevent serious harm to the child. This study aimed to evaluate the incidence of ROP and its association with known risk factors. DESIGN AND SETTING: Longitudinal incidence study in the neonatal intensive care unit (NICU) of Universidade Estadual de Montes Claros. METHODS: Newborns admitted to the NICU with gestational age less than 32 weeks and/or birth weight less than 1,500 grams, were followed up over a two-year period. The assessment and diagnosis of ROP were defined in accordance with a national protocol. The chi-square test or Fisher's exact test were used to determine associations between independent variables and ROP. Analysis on the independent effect of the variables on the results was performed using multiple logistic regression. RESULTS: The incidence of ROP was 44.5% (95% confidence interval, CI = 35.6-46.1) in the study population. The risk factors associated with the risk of developing the disease were: birth weight less than 1,000 grams (odds ratio, OR = 4.14; 95% CI = 1.34-12.77); gestational age less than 30 weeks (OR = 6.69; 95% CI = 2.10-21.31); use of blood derivatives (OR = 4.14; 95% CI = 2.99-8.99); and presence of sepsis (OR = 1.99; 95% CI = 1.45-2.40). CONCLUSIONS: The incidence of ROP was higher than that found in the literature. The main risk factors were related to extreme prematurity. RESUMO CONTEXTO E OBJETIVO:A retinopatia da prematuridade (ROP) é causa conhecida de cegueira e diagnóstico e tratamento oportunos podem evitar graves danos à criança. Este estudo objetivou avaliar a incidência da ROP e sua associação com fatores de risco conhecidos.

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“…12 This oxygen protocol adjusted the targeted oxygen saturation levels for all premature infants less than 34 weeks' postmenstrual age from a previous target of 90% to 99% downward, to 85% to 93%.…”

Section: Methodsmentioning

confidence: 99%

“…1 Thus, in recent work investigators have focused on potential prophylactic measures to minimize the incidence and severity of disease, with particular attention to maintaining a more strictly monitored, lower-oxygen saturation target. [2][3][4][5][6][7][8][9][10][11][12] However, recent prospective studies have encouraged caution in this regard because of an unexpected increase in mortality with the implementation of a stricter protocol. 9,13 Although these studies, in aggregate, suggest a correlation between a lower-oxygen saturation target and a decreased incidence and severity of ROP, they do not describe other effects it may have on the biologic behavior of the disease, an example of which is its postmenstrual age of onset.…”

mentioning

confidence: 99%