Retinopathy of Prematurity and Pulse Oximetry: A National Survey of Recent Practices

Anderson, Christina; Benitz, William Ε.; Madan, Ashima

doi:10.1038/sj.jp.7211067

Cited by 129 publications

(104 citation statements)

References 26 publications

(18 reference statements)

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“…Although the precise oxygen saturations to avoid remain unknown, avoiding hyperoxia, and particularly avoiding swings between hyperoxia and hypoxia, in the first few weeks of life has been shown to decrease the severity of ROP Askie and Henderson-Smart, 2000;Tin et al, 2001;Chow et al, 2003;Anderson et al, 2004;York et al, 2004). The relationship between hyperoxia and subsequent neovascularization appears more complex than suggested previously.…”

Section: Implications For Prevention and Treatment Of Ropmentioning

confidence: 97%

Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

618

527

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Collectively, angiogenic ocular conditions represent the leading cause of irreversible vision loss in developed countries. In the U.S., for example, retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration are the principal causes of blindness in the infant, working age and elderly populations, respectively. Evidence suggests that vascular endothelial growth factor (VEGF), a 40 kDa dimeric glycoprotein, promotes angiogenesis in each of these conditions, making it a highly significant therapeutic target. However, VEGF is pleiotropic, affecting a broad spectrum of endothelial, neuronal and glial behaviors, and confounding the validity of anti-VEGF strategies, particularly under chronic disease conditions. In fact, among other functions VEGF can influence cell proliferation, cell migration, proteolysis, cell survival and vessel permeability in a wide variety of biological contexts. This article will describe the roles played by VEGF in the pathogenesis of retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration. The potential disadvantages of inhibiting VEGF will be discussed, as will the rationales for targeting other VEGF-related modulators of angiogenesis.

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Section: Implications For Prevention and Treatment Of Ropmentioning

confidence: 97%

Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

618

527

View full text Add to dashboard Cite

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“…However, both the BOOST trial 13 and the STOP-ROP trial 16 showed detrimental effects in children randomized to high-vs. low-saturation regimes around gestational age 30 to 32 weeks and until close to term.…”

Section: Phasementioning

confidence: 99%

“…Several recent studies have shown a relationship between a high-oxygen saturation and ROP. [11][12][13][14] It seems that a SaO 2 >93% increases the risk for severe ROP and need for therapy. Furthermore, these studies also demonstrated more lung problems, including chronic lung disease, in infants nursed in a high-oxygen saturation.…”

Section: Introductionmentioning

confidence: 99%

Oxygen and retinopathy of prematurity

Saugstad

2006

J Perinatol

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Retinopathy of prematurity is on the rise and a third epidemic has been identified. In spite of extensive research and progress in the understanding of this disease in recent years, 50 000 children worldwide are blinded by this condition each year. The relation between hyperoxia, low-gestational age, growth retardation, oxygen dependent growth factors, and oxidative stress are now being understood more clearly. We know that in the first phase of retinopathy of prematurity, hyperoxia inhibits vascular endothelial growth factor. In the second phase, vascular endothelial growth factor rises, and when insulin-like growth factor-1 reaches a threshold around 32 to 34 weeks postconceptional age, uncontrolled neovascularization may occur. It is not known whether this new knowledge will have implications for future therapy. However, by strictly avoiding hyperoxia, that is, SaO 2 >92-93% and avoiding fluctuations in SaO 2 , it is possible to control and prevent severe retinopathy of prematurity in most cases.

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“…To decrease the risk of ROP, many neonatal intensive care units (NICUs) targeted lower SpO 2 in premature neonates receiving supplemental oxygen (12). Large randomized trials showed a reduction in severe ROP among survivors but increased mortality before discharge in extremely preterm infants when SpO 2 target was limited to 85-89% as compared to 91-95% from birth to 36 wk PMA (13,14).…”

mentioning

confidence: 99%

Graded oxygen saturation targets and retinopathy of prematurity in extremely preterm infants

et al. 2016

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Background:We compared the incidence of severe retinopathy of prematurity (ROP) and need for laser treatment before and after implementing graded pulse oximeter oxygen saturation (SpO 2 ) targets in extremely preterm infants. Mortality and other secondary outcomes were compared. Methods: Before 2002, we used 90-94% as the SpO 2 target in infants 24 0/7 -27 6/7 wk gestation and birth weight <1,000 g until 35 6/7 wk postmenstrual age (PMA). We implemented graded SpO 2 targets based on vaso-obliterative and vaso-proliferative phases of ROP in 2002. Group 1 (1995 (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) after implementation of graded SpO 2 targets based on PMA (83-89% until 32 6/7 wk, 90-94% until 35 6/7 wk and >94% at ≥ 36 wk PMA). results: There were 267 patients in Group 1 and 220 in Group 2. There was no significant difference in birth weight or gestational age. Severe ROP (adjusted OR: 0.18, 95% CI: 0.11, 0.30; P < 0.001) and laser surgery rates (adjusted OR: 0.31, 95% CI: 0.18, 0.52; P < 0.001) decreased significantly in Group 2. There was no difference in mortality (adjusted OR: 0.74, 95% CI: 0.37, 1.49; P = 0.40). conclusion: In this retrospective cohort study, implementation of graded SpO 2 targets decreased severe ROP and need for laser therapy, without increasing mortality.before, and Group 2

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Retinopathy of Prematurity and Pulse Oximetry: A National Survey of Recent Practices

Cited by 129 publications

References 26 publications

Vascular endothelial growth factor in eye disease

Vascular endothelial growth factor in eye disease

Oxygen and retinopathy of prematurity

Graded oxygen saturation targets and retinopathy of prematurity in extremely preterm infants

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