The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

LOWER PERCENT OXYGEN SATURATION GOAL REDUCES INCIDENCE AND SEVERITY OF RETINOPATHY OF PREMATURITY IN VERY LOW BIRTH WEIGHT INFANTS.



Jamie Nystrom, RRT, RN; Gerald Nystrom, MD. Presbyterian Hospital of Dallas, Dallas, TX

Chow, et al reported a dramatic reduction in Retinopathy of Prematurity (ROP) and Severe (stage 3 and 4) ROP in Very Low Birth Weight (VLBW) infants ≤ 1500 grams birth weight when a policy of accepting lower % O2 saturation limits (83-85%) and avoidance of higher % O2 saturations (> 93%) was accepted in their NICU (Pediatrics 2003; 111:339-345).

We asked whether accepting lower % O2 saturations and avoidance of higher % O2 saturation would reduce the incidence and severity of ROP in our NICU.

In Oct 2004 we completed a multidisciplinary education program and standardized our % O2 saturation goals for VLBW infants ≤ 1500 grams birth weight (goal % O2 saturation 85-92% with alarm limits set at 80% and 95%). We then compared the impact of these changes on survival and incidences of ROP and severe ROP in VLBW infants we managed before and after the standardization of % O2 saturation goals in our NICU. Our data are summarized in the following table:

  2002 2003 10/1/04 - 5/31/05
 n %n %n %
≤ 1500 g
birth weight

180
 
111
 
106
 

Survived

149

83%

92

83%

92

88%

Any ROP

59

40%

38

41%

18

20%

Severe ROP

20

13%

14

15%

1

1%

Our preliminary experience suggests that the incidence and severity of ROP can be dramatically reduced by allowing VLBW infants to be managed with lower %O2 saturation goals (85-92%) and limiting their exposure to high %O2 saturations (> 92%). This strategy was not associated with decreased survival and may have the secondary benefits of shorter duration of mechanical ventilation and lower rates of chronic lung disease.

You are here: RCJournal.com » Past OPEN FORUM Abstracts » 2005 Abstracts » LOWER PERCENT OXYGEN SATURATION GOAL REDUCES INCIDENCE AND SEVERITY OF RETINOPATHY OF PREMATURITY IN VERY LOW BIRTH WEIGHT INFANTS.