Supplementary Material for: Variations in Oxygen Saturation Targeting, and Retinopathy of Prematurity Screening and Treatment Criteria in Neonatal Intensive Care Units: An International Survey

<b><i>Background:</i></b> Rates of retinopathy of prematurity (ROP) and ROP treatment vary between neonatal intensive care units (NICUs). Neonatal care practices, including oxygen saturation (SpO₂) targets and criteria for the screening and treatment of ROP, are potential contributing factors to the variations. <b><i>Objectives:</i></b><i></i> To survey variations in SpO₂ targets in 2015 (and whether there had been recent changes) and criteria for ROP screening and treatment across the networks of the International Network for Evaluating Outcomes in Neonates (iNeo). <b><i>Methods:</i></b> Online prepiloted questionnaires on treatment practices for preterm infants were sent to the directors of 390 NICUs in 10 collaborating iNeo networks. Nine questions were asked and the results were summarized and compared. <b><i>Results:</i></b> Overall, 329/390 (84%) NICUs responded, and a majority (60%) recently made changes in upper and lower SpO₂ target limits, with the median set higher than previously by 2–3% in 8 of 10 networks. After the changes, fewer NICUs (15 vs. 28%) set an upper SpO₂ target limit &gt; 95% and fewer (3 vs. 5%) a lower limit &lt; 85%. There were variations in ROP screening criteria, and only in the Swedish network did all NICUs follow a single guideline. The initial retinal examination was carried out by an ophthalmologist in all but 6 NICUs, and retinal photography was used in 20% but most commonly as an adjunct to indirect ophthalmoscopy. <b><i>Conclusions:</i></b> There is considerable variation in SpO₂ targets and ROP screening and treatment criteria, both within networks and between countries.

<b><i>研究背景：</i></b> 早产儿视网膜病变（retinopathy of prematurity, ROP）的发病率及ROP治疗方案在各新生儿重症监护室（neonatal intensive care unit, NICU）间存在显著差异。新生儿护理操作规范——包括血氧饱和度（SpO₂）目标值、ROP筛查与治疗标准——或是造成此类差异的潜在影响因素。<b><i>研究目的：</i></b> 针对国际新生儿结局评估网络（International Network for Evaluating Outcomes in Neonates, iNeo）旗下各协作网络，调研其2015年的血氧饱和度目标值设置情况（含近期是否有调整），以及ROP筛查与治疗的相关标准。<b><i>研究方法：</i></b> 针对10个iNeo协作网络中的390家NICU负责人，发放经预试验优化的早产儿护理操作线上问卷。问卷共设置9个问题，最终对回收结果进行汇总与对比分析。<b><i>研究结果：</i></b> 总体而言，390家NICU中共有329家完成问卷反馈，回收率达84%；其中60%的机构近期调整了血氧饱和度上下限目标值，10个协作网络中有8个的中位目标值较此前提升了2%~3%。调整完成后，将血氧饱和度上限目标值设为＞95%的NICU占比从28%降至15%，将下限设为＜85%的机构占比从5%降至3%。ROP筛查标准同样存在地域差异，仅瑞典协作网络内的所有NICU均遵循统一指南。除6家机构外，其余所有NICU的首次眼底检查均由眼科医师完成；20%的机构采用眼底摄影技术，但多数情况下该技术仅作为间接检眼镜检查的辅助手段。<b><i>研究结论：</i></b> 各协作网络内部以及不同国家间，血氧饱和度目标值、ROP筛查与治疗标准均存在显著差异。