期刊
SEMINARS IN PERINATOLOGY
卷 43, 期 6, 页码 333-340出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.semperi.2019.05.004
关键词
Retinopathy of prematurity; Very preterm infants; Oxygen saturation targeting; Middle-income countries; Prevention of morbidity; Randomised controlled trials
Reducing the burden of visual morbidity from retinopathy of prematurity (ROP) begins with primary prevention, and improvements in neonatal care with a positive impact on ROP are possible in all settings. Strategies range from rigorous adoption of inexpensive evidence-based protocols, for example on temperature control, prevention of sepsis and support for breast-milk feeding, through to comprehensive quality improvement programmes, and fostering team work and camaraderie. Oxygen monitoring is essential for very preterm infants receiving supplementary oxygen. The Neonatal Oxygenation Prospective Meta-analysis (NeOProM) collaboration has reported analysis of five trials of oxygen saturation (SpO(2)) targeting in very preterm infants and shown that a SpO(2) target of 85-89% compared to 91-95% was associated with increased mortality (on average 28 extra deaths for every 1000 infants treated). Adopting a SpO(2) target higher than 85-89% might increase the risk of ROP for some infants, highlighting the importance of pursuing all other means of prevention. (C) 2019 Elsevier Inc. All rights reserved.
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