The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

CARDIORESPIRATORY DECOMPENSATION ASSOCIATED WITH LASER SURGERY FOR RETINOPATHY OF PREMATURITY

Jamie Nystrom, RRT, RN; Lisa Kahl, RN; Ian Ratner, MD; Jonathon Whitfield, MD; Gerald Nystrom, MD. Presbyterian Hospital of Dallas, Dallas, TX.

We reviewed the cardiorespiratory status of infants before and after laser surgery for Retinopathy of Prematurity (ROP) to determine factors that may predict need for respiratory support during or after the laser surgery procedure. Data were available for 44 (96%) of the 46 laser surgery procedures in 43 (98%) of the 44 infants (birth weight 400-980 grams) receiving laser surgery in three major Dallas hospitals from January 1, 2002 through December 31, 2003. Post-menstrual age at laser surgery appeared to have the greatest impact on the need for additional peri-operative respiratory assistance. All infants ≤ 36 weeks post-menstrual age at laser procedure required respiratory assistance during the laser surgery procedure, including 62% that required peri-operative intubation. Conversely, no infant > 37 weeks post-menstrual age required intubation and only 25% required increase in respiratory support during the laser surgery procedure. Infants 37 weeks post-menstrual age had intermediate findings with 63% requiring either respiratory assistance or peri-operative intubation (see figure).

We conclude strong consideration should be given to electively intubating or increasing the respiratory support of infants ≤ 36 weeks post-menstrual age prior to undergoing laser surgery for ROP. Elective intubation is not routinely needed for infants > 37 weeks post-menstrual age for laser surgery.

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