The effect of lowering target oxygen saturation on retinopathy of prematurity in neonatal respiratory distress syndrome

Abstract

AIM: To determine the effect of lowered target oxygen saturation levels on and identify risk factors of retinopathy of prematurity ( ROP ) in neonatal respiratory distress syndrome (RDS). METHODS: Medical records of consecutive preterm infants (N = 252) diagnosed with RDS between Jan. 2009 and Dec. 2012 were retrospectively reviewed. The patients were divided into higher - saturation (90 - 97% ; n = 116 ) and lower-saturation (85-93% ; n = 136) groups according to their target oxygen saturation ranges. ROP severity was assessed and relevant systemic parameters were evaluated. RESULTS: Incidence of ROP, need for laser ablation, and proportion of aggressive posterior ROP were not significantly different between the groups, but the lowersaturation group had a better survival rate (P = 0. 005). Patients who spent an additional day in incubator care had a 1. 041 times greater chance of developing ROP (odds ratio = 1. 041; 95% CI = 1. 003-2. 275; P = 0. 002), whereas a one- point increase in the 5min Apgar score reduced the possibility by 24. 7% (odds ratio = 0. 753; 95% CI = 0. 152 - 0.965; P = 0. 033). CONCLUSION: Target oxygen saturation levels of 85% to 93% may improve survival without affecting ROP development in infants with RDS. The relevant risk factors are duration of incubator care and 5-min Apgar score.