Retinopathy of prematurity: analysis of a damage reduction attempt

Abstract Objective: To evaluate the efficacy of an oxygen saturation reduction protocol used to supplement preterm newborns (PTNB) hospitalized in a neonatal ICU to prevent the onset of retinopathy of prematurity (ROP). Methods: This is a cohort study performed in a single Neonatal ICU. The first group (pre-protocol, n = 30) used oxygen with hemoglobin saturation > 95%. Since the institution of a new oxygen therapy protocol that maintained hemoglobin saturation between 90% and 95%, the second group was obtained (post-protocol n = 28). All included preterm infants had a gestational age of less than or equal to 32 weeks and / or birth weight of 1500 g or less, retinal mappings from 28 days of life and follow up for up to 45 weeks of corrected gestational age. Results: 58 cases were studied, excluding those who died (15/58; 26.8%), ROP was diagnosed in 15/43 patients (34.9%). The lower gestational age significantly influenced the appearance of ROP (p = 0.002). Regarding the number of ROP cases and deaths, no statistically significant difference was observed between groups. Oxygen therapy time was significantly associated with the presence of ROP in both groups. Boys were six times more affected by ROP than girls. Conclusion: Reduction of oxygen saturation was not effective in reducing the number of cases of ROP.摘要 研究目的：评估用于辅助新生儿重症监护病房（Neonatal Intensive Care Unit, NICU）住院的早产新生儿（Preterm Newborns, PTNB）的血氧饱和度降低方案的疗效，以预防早产儿视网膜病变（Retinopathy of Prematurity, ROP）的发生。 研究方法：本研究为单中心新生儿重症监护病房队列研究。第一组为方案实施前队列（n=30），采用维持血红蛋白饱和度＞95%的氧疗策略。随着本机构推行维持血红蛋白饱和度介于90%~95%的新型氧疗方案，纳入第二组即方案实施后队列（n=28）。所有纳入研究的早产婴儿均满足胎龄≤32周且/或出生体重≤1500g的纳入标准，均于出生后28天完成视网膜成像检查，并随访至校正胎龄达45周。 研究结果：本研究共纳入58例病例，排除其中死亡的15例（占比26.8%），剩余43例患者中确诊早产儿视网膜病变者15例（占比34.9%）。更低的胎龄对ROP的发生具有显著影响（p=0.002）。在ROP病例数与死亡病例数方面，两组间未观察到统计学显著性差异。氧疗时长与两组中ROP的发生均存在显著相关性。男性婴儿发生ROP的风险为女性婴儿的6倍。 研究结论：降低血氧饱和度未能有效减少早产儿视网膜病变的发病例数。