Dataset Information

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms.

ABSTRACT:

Objective

To identify achieved oxygen saturations (SpO₂) associated with increased risk of severe retinopathy of prematurity (ROP).

Design

This is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO₂ was recorded up to 36 weeks' postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.

Setting

20 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.

Patients

984 surviving infants of 24-27 weeks' gestational age born in 2005-2009.

Interventions

SUPPORT targeted SpO₂ to a lower (85%-89%) or higher (91%-95%) range through 36 weeks' postmenstrual age or off respiratory support.

Main outcome measures

Severe ROP defined as threshold ROP, ophthalmological surgery or bevacizumab treatment.

Results

There were statistically significant interactions between duration of oxygen supplementation and percentage of time in certain achieved saturation ranges. Specifically, for infants who spent at least 2 weeks on oxygen in postnatal weeks 1-5, a higher percentage of time at 91%-96%?SpO₂ was associated with increased odds of severe ROP. For infants who spent at least 3 weeks on oxygen in postnatal weeks 6-9, a higher percentage of time at 97%-100%?SpO₂ was associated with increased odds of severe ROP. Other significant risk factors were lower gestational age and birth weight, non-Hispanic white versus black race, prospectively defined severe illness, late-onset sepsis or meningitis, and clinical centre.

Conclusions

Among extremely preterm survivors to discharge, the association between SpO₂ and severe ROP depended on the timing and duration of oxygen supplementation.

SUBMITTER: Gantz MG

PROVIDER: S-EPMC6925651 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms.

Gantz Marie G MG Carlo Waldemar A WA Finer Neil N NN Rich Wade W Faix Roger G RG Yoder Bradley A BA Walsh Michele C MC Newman Nancy S NS Laptook Abbott A Schibler Kurt K Das Abhik A Higgins Rosemary D RD

Archives of disease in childhood. Fetal and neonatal edition 20190622 2

<h4>Objective</h4>To identify achieved oxygen saturations (SpO<sub>2</sub>) associated with increased risk of severe retinopathy of prematurity (ROP).<h4>Design</h4>This is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO<sub>2</sub> was recorded up to 36 weeks' postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.<h4>S ...[more]

PMID: 31229956

Similar Datasets

Project description:ImportanceThe Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial (SUPPORT) demonstrated that static low oxygen saturation decreased retinopathy of prematurity (ROP) but increased mortality compared with static high oxygen saturation cohorts.ObjectiveTo compare outcomes of a biphasic oxygen protocol with static targets recommended by SUPPORT.Design, setting, and participantsRetrospective cohort study comparing biphasic vs static standards 41 months prior to and 42 months after a change from biphasic to static SUPPORT standards at a level III neonatal intensive care unit (Fairview Hospital, Cleveland, Ohio). The study included infants born at a corrected gestational age (CGA) of 31 weeks or younger or birth weight 1500 g or less. Data were analyzed between August 2010 and July 2017.InterventionsThe pre-SUPPORT group underwent biphasic protocol target saturations of 85% to 92% at younger than 34 weeks' CGA and greater than 95% at 34 weeks' CGA or older. The post-SUPPORT group underwent a constant 91% to 95% target.Main outcomes and measuresPrimary outcome was incidence of type 1 ROP. Secondary outcomes were incidence of any ROP, time to full vascularization, and mortality.ResultsOf 596 eligible infants, 562 were included in ophthalmic analysis. Three hundred three patients were boys (54%); 399 were white (71%), 87 were black (15%), and 76 were of other or unknown race/ethnicity (14%). Mean (SD) CGA and birth weight were 29 (2) weeks and 1151 (346) g, respectively. Any ROP overall increased (53 [20%] pre-SUPPORT vs n = 86 [28%] post-SUPPORT; absolute difference, 8%; 95% CI, 1%-15%; odds ratio, 1.6; 95% CI, 1.05-2.3; P = .03). Type 1 ROP increased in the post-SUPPORT era (n = 6 [2%] pre-SUPPORT vs n = 18 [6%] post-SUPPORT; absolute difference, 4%; 95% CI, 0.4%-7%; odds ratio, 2.7; 95% CI, 1.05-6.9; P = .03). There was a delay in vascularization in the post-SUPPORT group (n = 6 [2%] pre-SUPPORT vs n = 18 [6%] post-SUPPORT; absolute difference, 4%; 95% CI, 0.4%-7%; P = .03).Conclusions and relevanceCompared with static oxygen standards, biphasic oxygen targets are associated with decreased incidence and severity of ROP without increasing mortality.

Dataset Information

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms.

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Conclusions

Publications

Achieved oxygen saturations and retinopathy of prematurity in extreme preterms.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets