A Change in Oxygen Supplementation Can Decrease the Incidence of Retinopathy of Prematurity
A Change in Oxygen Supplementation Can Decrease the Incidence of Retinopathy of Prematurity
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DOI：
10.1016/j.ophtha.2008.09.051
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发表时间：
2009-03-01
期刊：
影响因子：
13.7
通讯作者：
Hoppe, George
中科院分区：
文献类型：
--
作者：
Sears, Jonathan E.;Pietz, Jeffrey;Hoppe, George
目的：为了确定早产儿视网膜病变（ROP）的发病率超过2年的时间之前和之后的变化，在实践中的oxygensupplement.Design：非随机，回顾性研究。参与者：所有婴儿在一个单一的三级新生儿重症监护病房之间的2005年和2007年。一个前瞻性数据库记录了胎龄、出生体重、ROP的分期和区域、阈值疾病、治疗、最终结局和检查日期、孕产妇和婴儿人口统计学资料以及新生儿重症监护室课程。第1年（2005年8月1日至2006年7月31日）包括接受标准氧补充方案的患者队列，该方案的氧目标为95%至100%饱和度。第2年（2006年8月1日至2007年7月31日）纳入了一个患者队列，该患者严格监测了34周的氧目标，校正胎龄限制为85%至100%，目标饱和度为92%至97%。氧气方案改变前第1年的ROP发生率与氧气方案改变后第2年的ROP发生率进行比较。一年级共有114名儿童，二年级有108名儿童被确定为出生或转移到锦绣幼儿园。在氧气标准改变之前检查了98名婴儿，在氧气标准改变之后检查了92名婴儿，包括2005年9月至2007年10月期间检查的190名连续患者。在氧气方案改变前，第1组中35%的婴儿存在ROP，而氧气标准改变后为13%（P = 0.001）; 3期从11%降至2%（P = 0.021）;阈值疾病从7%降至1%（P = 0.066）。0期（未成熟血管，无ROP）发生率增加（氧变化前/后30%/51%，P = 0.001）。分娩方式（P = 0.007）、败血症
Purpose: To determine the incidence of retinopathy of prematurity (ROP) over a 2-year period before and after a change in the practice of oxygen supplementation.Design: Nonrandomized, retrospective study.Participants: All infants in a single Level III neonatal intensive care unit between the years of 2005 and 2007.Methods: A prospective database recorded the gestational age, birth weight, stage and zone of ROP, threshold disease, treatment, final outcome and date of examination, maternal and infant demographics, and neonatal intensive care unit course. Year 1 (August 1, 2005 to July 31, 2006) includes a patient cohort who received the standard oxygen supplementation protocol, which has oxygen targets of 95% to 100% saturation. Year 2 (August 1, 2006 to July 31, 2007) includes a patient cohort who has strictly monitored oxygen targets of 34 weeks corrected gestational age limits of 85% to 100% and target 92% to 97% saturation.Main Outcome Measure: Incidence of ROP in year 1 before a change in oxygen protocol compared with the incidence of ROP in year 2 after a change in the oxygen protocol.Results: A total of 114 children in year 1 and 108 children in year 2 were identified as having been born or transferred to the Fairview Nursery. Ninety-eight infants were examined before and 92 infants were examined after the change in oxygen standards, comprising 190 consecutive patients examined between September 2005 and October 2007. ROP was present in 35% of infants in group 1 before the change in oxygen protocol compared with 13% after the change in oxygen standards (P = 0.001); stage 3 decreased from 11% to 2% (P = 0.021); threshold disease decreased from 7% to 1% (P = 0.066). Stage 0 (immature vessels, no ROP) incidence increased (pre/post-oxygen change 30%/51% stage 0, P = 0.001). There were statistically significant differences in mode of delivery (P = 0.007), sepsis