Postnatal cerebral hyperoxia tied to increased risk for severe retinopathy of prematurity

  • Richter AE & al.
  • Neonatology
  • 5 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Cerebral hyperoxia burden within the first 96 hours after birth was associated with an increased risk for severe retinopathy of prematurity (ROP).

Why this matters

  • Findings suggest that cerebral oxygen saturation (rcSO2) may be more sensitive to detect the risk for severe ROP than arterial oxygen saturation (SaO2) in early infancy.

Study design

  • Retrospective analysis of 225 preterm infants born ≤30 weeks’ gestation (median gestational age, 28.0 weeks; mean birth weight, 1032 g) and admitted to the neonatal intensive care unit.
  • Burden of cerebral and arterial hyperoxia (defined as the percentage of time spent at saturation thresholds exceeding 85% and 90%, respectively) was calculated.
  • Funding: Junior Scientific Master Class of the University of Groningen.

Key results

  • Overall, 30 infants developed mild ROP and 8 developed severe ROP.
  • Infants with severe ROP vs those without had a higher burden of cerebral hyperoxia (30%; interquartile range [IQR], 3-76% vs 16%; IQR, 5-33%).
  • On day 2, infants with severe ROP vs those without spent more time at cerebral hyperoxic levels (53% vs 17%).
  • Every 10% more time spent above a rcSO2 threshold of 85% during the first 4 days after birth, the risk for severe ROP was doubled (OR, 1.50; 95% CI, 1.09-2.06; P=.013).
  • No association was observed between the burden of arterial hyperoxia and ROP.

Limitations

  • Retrospective design.
  • Small sample size.