Prevention of retinopathy of prematurity in preterm infants through changes in clinical practice and SpO₂technology.
OBJECTIVE
To identify whether pulse oximetry technology is associated with decreased retinopathy of prematurity (ROP) and laser treatment.


METHODS
Inborn infants <1250 g who had eye exams were compared at two centres in three periods. In Period 1, SpO₂ target was ≥93% and pulse oximetry technology was the same in both Centres. In Period 2, guidelines for SpO₂ 88-93% were implemented at both centres and Centre B changed to oximeters with signal extraction technology (SET(®)) while Centre A did not, but did so in Period 3. One ophthalmology department performed eye exams using international criteria.


RESULTS
In 571 newborns <1250 g, birth weight and gestational age were similar in the different periods and centres. At Centre A, severe ROP and need for laser remained the same in Periods 1 and 2, decreasing in Period 3-6% and 3%, respectively. At Centre B, severe ROP decreased from 12% (Period 1) to 5% (Period 2) and need for laser decreased from 5% to 3%, remaining low in Period 3.


CONCLUSIONS
In a large group of inborn infants <1250 g, a change in clinical practice in combination with pulse oximetry with Masimo SET, but not without it, led to significant reduction in severe ROP and need for laser therapy. Pulse oximetry selection is important in managing critically ill infants.
Castillo
Armando
A
Northeast Georgia Medical Center, Gainesville, USA.
Deulofeut
Richard
R
Critz
Ann
A
Sola
Augusto
A
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000032:analysis; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000517:prevention & control*; D012720:Severity of Illness Index
D010100:Oxygen
Am J Ophthalmol. 2006 Jan;141(1):167-74
16386993
Acta Paediatr. 2000 May;89(5):571-6
10852195
Pediatrics. 2010 Jun;125(6):e1483-92
20498174
Anesth Analg. 2000 Jun;90(6):1336-40
10825316
Arch Dis Child Fetal Neonatal Ed. 2003 Nov;88(6):F505-8
14602699
J Perinatol. 2006 Nov;26(11):700-5
17036032
Anesth Analg. 2002 Jan;94(1 Suppl):S81-3
11900045
BMC Pediatr. 2005 Jun 28;5(1):18
15985170
Anesth Analg. 2004 Sep;99(3):793-796
15333413
Acta Paediatr. 2007 Jul;96(7):990-4
17577339
Pediatrics. 2008 May;121(5):882-9
18450890
Ophthalmology. 2009 Mar;116(3):513-8
19157560
Angiogenesis. 2007;10(2):133-40
17332988
Semin Neonatol. 2003 Dec;8(6):469-73
15001119
J Perinatol. 2008 May;28 Suppl 1:S28-34
18446174
Ann Acad Med Singap. 2005 Mar;34(2):169-78
15827664
Anesth Analg. 2002 Jan;94(1 Suppl):S41-3
11900037
Crit Care Med. 2002 Aug;30(8):1735-40
12163785
J Perinatol. 2004 Feb;24(2):82-7
14762452
J Intensive Care Med. 2004 Jul-Aug;19(4):229-34
15296623
N Engl J Med. 2010 May 27;362(21):1959-69
20472937
S Afr Med J. 2002 Dec;92(12):986-90
12561416
N Engl J Med. 1992 Apr 16;326(16):1050-4
1549150
Arch Ophthalmol. 1997 May;115(5):604-8
9152127
Pediatrics. 2003 Feb;111(2):339-45
12563061
Trans Am Ophthalmol Soc. 2006;104:78-84
17471328
J Perinatol. 2002 Jul-Aug;22(5):360-6
12082469
Crit Care Med. 2000 May;28(5):1565-8
10834712
Pediatrics. 2001 Sep;108(3):809-11
11533356