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Retinopathy of prematurity (ROP) was first observed soon after the widespread introduction of oxygen therapy into neonatal care. Early trials suggested that restricting oxygen supplementation could reduce ROP without other consequences, but when oxygen restriction became widespread, increased mortality was observed. These observations were made before continuous monitoring of oxygenation was possible. New trial evidence from masked randomized controlled trials of different pulse oximeter oxygen saturation (SpO2) target ranges now shows that targeting lower SpO2 levels reduces ROP but is associated with significantly increased mortality. These results illustrate the importance of randomized trials because, prior to these recent studies, trends in practice based on observational data were favouring lower SpO2. Follow-up data may yet further inform clinical practice.
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- SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network, Carlo WA, Finer NN, Walsh MC, Rich W, Gantz MG, Laptook AR, Yoder BA, Faix RG, Das A, Poole WK, Schibler K, Newman NS, Ambalavanan N, Frantz ID 3rd, Piazza AJ, Sánchez PJ, Morris BH, Laroia N, Phelps DL, Poindexter BB, Cotten CM, Van Meurs KP, Duara S, Narendran V, Sood BG, O'Shea TM, Bell EF, Ehrenkranz RA, Watterberg KL, Higgins RD: Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med 2010;362:1959-1969.
- Stenson B, Brocklehurst P, Tarnow-Mordi W: Increased 36-week survival with high oxygen saturation target in extremely preterm infants. UK BOOST II trial; Australian BOOST II trial; New Zealand BOOST II trial. N Engl J Med 2011;364:1680-1682.
- Vaucher YE, Peralta-Carcelen M, Finer NN, Carlo WA, Gantz MG, Walsh MC, et al: Neurodevelopmental outcomes in the early CPAP and pulse oximetry trial. N Engl J Med 2012;367:2495-2504.
- Terry TL: Fibroblastic overgrowth of persistent tunica vasculosa lentis in infants born prematurely. II. Report of cases-clinical aspects. Trans Am Ophthalmol Soc 1942;40:262-284.
- Campbell K: Intensive oxygen therapy as a possible cause of retrolental fibroplasia; a clinical approach. Med J Aust 1951;2:48-50.
- Kinsey VE: Retrolental fibroplasia; cooperative study of retrolental fibroplasia and the use of oxygen. AMA Arch Ophthalmol 1956;56:481-543.
- Cross KW: Cost of preventing retrolental fibroplasia? Lancet1973;2:954-956.
- Kinsey VE, Arnold HJ, Kalina RE, Stern L, Stahlman M, Odell G, et al: PaO2 levels and retrolental fibroplasia: a report of the cooperative study. Pediatrics 1977;60:655-668.
- Yu VY, Hookham DM, Nave JR: Retrolental fibroplasia - controlled study of 4 years' experience in a neonatal intensive care unit. Arch Dis Child 1982;57:247-252.
- Bancalari E, Flynn J, Goldberg RN, Bawol R, Cassady J, Schiffman J, Feuer W, Roberts J, Gillings D, Sim E: Influence of transcutaneous oxygen monitoring on the incidence of retinopathy of prematurity. Pediatrics 1987;79:663-669.
- Flynn JT, Bancalari E, Snyder ES, Goldberg RN, Feuer W, Cassady J, et al: A cohort study of transcutaneous oxygen tension and the incidence and severity of retinopathy of prematurity. Trans Am Ophthalmol Soc 1991;89:77-92.
- Myers TR: AARC Clinical Practice Guideline: selection of an oxygen delivery device for neonatal and pediatric patients - 2002 revision and update. Respir Care 2002;47:707-716.
- American Academy of Pediatrics, American College of Obstetricians and Gynecologists, March of Dimes Birth Defects Foundation: Guidelines for Perinatal Care, ed 6. Washington, American Academy of Pediatrics and American College of Obstetricians and Gynecologists, 2007.
- Tin W, Milligan DW, Pennefather P, Hey E: Pulse oximetry, severe retinopathy, and outcome at one year in babies of less than 28 weeks' gestation. Arch Dis Child Fetal Neonatal Ed 2001;84:F106-F110.
- Anderson CG, Benitz WE, Madan A: Retinopathy of prematurity and pulse oximetry: a national survey of recent practices. J Perinatol 2004;24:164-168.
- Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP), a randomized, controlled trial. I. Primary outcomes. Pediatrics 2000;105:295-310.
- Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM: Oxygen-saturation targets and outcomes in extremely preterm infants. N Engl J Med 2003;349:959-967.
- Chow LC, Wright KW, Sola A, CSMC Oxygen Administration Study Group: Can changes in clinical practice decrease the incidence of severe retinopathy of prematurity in very low birth weight infants? Pediatrics 2003;111:339-345.
- Askie LM, Brocklehurst P, Darlow BA, Finer N, Schmidt B, Tarnow-Mordi W, NeOProM Collaborative Group: NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol. BMC Pediatr 2011;11:6.
- Johnston ED, Boyle B, Juszczak E, King A, Brocklehurst P, Stenson BJ: Oxygen targeting in preterm infants using the Masimo SET Radical pulse oximeter. Arch Dis Child Fetal Neonatal Ed 2011;96:F429-F433.
- Saugstad OD, Speer CP, Halliday HL: Oxygen saturation in immature babies: revisited with updated recommendations. Neonatology 2011;100:217-218.
- Quine D, Stenson BJ: Arterial oxygen tension (PaO2) values in infants <29 weeks of gestation at currently targeted saturations. Arch Dis Child Fetal Neonatal Ed 2009;94:F51-F53.
- Hagadorn JI, Furey AM, Nghiem TH, Schmid CH, Phelps DL, Pillers DA, Cole CH, AVIOx Study Group: Achieved versus intended pulse oximeter saturation in infants born less than 28 weeks' gestation: the AVIOx study. Pediatrics 2006;118:1574-1582.
- Claure N, Bancalari E, D'Ugard C, Nelin L, Stein M, Ramanathan R, Hernandez R, Donn SM, Becker M, Bachman T: Multicenter crossover study of automated control of inspired oxygen in ventilated preterm infants. Pediatrics 2011;127:e76-e83.