Can Changes in Clinical Practice Decrease the Incidence of Severe Retinopathy of Prematurity in Very Low Birth Weight Infants?

Chow, Lily C.; Wright, Kenneth W.; Sola, Augusto

doi:10.1542/peds.111.2.339

Cited by 461 publications

(296 citation statements)

References 28 publications

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“…There has been recent evidence that reduced oxygen can reduce the incidence of ROP even among the very small babies, which survive. [23][24][25] We feel that the whole focus should be brought back to oxygen. Even in this study, there were two babies weighing more than 2000 g at birth similar to Gopal et al 16 and 11 with gestational age more than 32 weeks.…”

Section: Discussionmentioning

confidence: 99%

Anatomical and visual outcome of stages 4 and 5 retinopathy of prematurity

Shah

Narendran

et al. 2007

Eye

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Section: Discussionmentioning

confidence: 99%

Anatomical and visual outcome of stages 4 and 5 retinopathy of prematurity

Shah

Narendran

et al. 2007

Eye

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“…There are a number of recent reports that suggest improved outcomes for BPD and ROP with tolerance of lower SpO 2 values. 17,18 However, neither of these reports document changes in SpO 2 values but correlate changes in outcome with differing policy for use of pulse oximetry. It is not the intention of this study to conclude that increased time with lower SpO 2 values was deleterious or beneficial based on the present observations.…”

Section: Discussionmentioning

confidence: 99%

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

et al. 2006

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Objective: To determine if a change in the pulse oximeter goal range and high alarm limit for oxygen saturation (SpO 2 ) alters the distribution of SpO 2 for premature infants in oxygen.Study design: This was a prospective, observational analysis. For group 1 (February 2002 to April 2002, n ¼ 23), pulse oximeter alarms were set at 80% (low) and 96% (high), and the goal range was 90-95%. For group 2 (May 2002 to August 2003, n ¼ 49), the high alarm was lowered to 94%, and the goal range was 88 to 94%. The SpO 2 values for 24 h were downloaded from Nellcor pulse oximeters during the two periods and the percent time within, above and below the goal range was derived and compared.Results: Groups were similar except for use of post-natal steroids (group 2>1). The percent time within (57.7±9.8 vs 59.4±12.4%), above (15.4±10.6 vs 14±9.4%) and below (26.9±9.7 vs 26.6±10.2%) the goal range was similar for groups 1 and 2, respectively. However, the percent time with SpO 2 <80% increased significantly for group 2 (4.0±2.7 vs 1.9±1.4%).Conclusions: Changes in pulse oximeter policy and alarms in labile, sick premature infants need evaluation for their effects on the distribution of SpO 2 values before routine use.

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“…Although the precise oxygen saturations to avoid remain unknown, avoiding hyperoxia, and particularly avoiding swings between hyperoxia and hypoxia, in the first few weeks of life has been shown to decrease the severity of ROP Askie and Henderson-Smart, 2000;Tin et al, 2001;Chow et al, 2003;Anderson et al, 2004;York et al, 2004). The relationship between hyperoxia and subsequent neovascularization appears more complex than suggested previously.…”

Section: Implications For Prevention and Treatment Of Ropmentioning

confidence: 98%

Vascular endothelial growth factor in eye disease

Penn

Madan

Caldwell

et al. 2008

Progress in Retinal and Eye Research

636

527

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Collectively, angiogenic ocular conditions represent the leading cause of irreversible vision loss in developed countries. In the U.S., for example, retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration are the principal causes of blindness in the infant, working age and elderly populations, respectively. Evidence suggests that vascular endothelial growth factor (VEGF), a 40 kDa dimeric glycoprotein, promotes angiogenesis in each of these conditions, making it a highly significant therapeutic target. However, VEGF is pleiotropic, affecting a broad spectrum of endothelial, neuronal and glial behaviors, and confounding the validity of anti-VEGF strategies, particularly under chronic disease conditions. In fact, among other functions VEGF can influence cell proliferation, cell migration, proteolysis, cell survival and vessel permeability in a wide variety of biological contexts. This article will describe the roles played by VEGF in the pathogenesis of retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration. The potential disadvantages of inhibiting VEGF will be discussed, as will the rationales for targeting other VEGF-related modulators of angiogenesis.

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Can Changes in Clinical Practice Decrease the Incidence of Severe Retinopathy of Prematurity in Very Low Birth Weight Infants?

Cited by 461 publications

References 28 publications

Anatomical and visual outcome of stages 4 and 5 retinopathy of prematurity

Anatomical and visual outcome of stages 4 and 5 retinopathy of prematurity

Pulse oximetry in very low birth weight infants: can oxygen saturation be maintained in the desired range?

Vascular endothelial growth factor in eye disease

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