Related Experiment Videos
Retinopathy of prematurity. A randomized, prospective trial of transcutaneous oxygen monitoring
Insights
Continuous transcutaneous oxygen monitoring (tcPO2) did not significantly reduce retinopathy of prematurity (ROP) in premature infants. However, it showed a trend towards lower ROP incidence in specific weight groups, warranting further investigation.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Medical Technology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Oxygen therapy is crucial for premature infants but carries a risk of ROP.
- Transcutaneous oxygen monitoring (tcPO2) offers a method to manage oxygen levels.
Purpose of the Study:
- To evaluate if continuous tcPO2 monitoring reduces ROP incidence in high-risk premature infants.
- To compare continuous monitoring with standard intermittent monitoring of oxygen levels.
Main Methods:
- A randomized, prospective trial involving 296 premature infants at high risk for ROP.
- Infants were assigned to continuous monitoring (CM) or standard care (SC) groups.
- tcPO2 was continuously monitored in the CM group and intermittently in the SC group.
Main Results:
- Overall ROP incidence was 51% in the CM group and 59% in the SC group (not significant).
- Survival rates were 101/148 in CM and 113/148 in SC.
- A higher birthweight in the SC group correlated with increased ROP risk, with an odds ratio of 7.6 in infants 1200-1300g and Apgar scores >=8.
Conclusions:
- Continuous tcPO2 monitoring did not significantly decrease the overall incidence of ROP.
- Further research may be needed to explore the potential benefits in specific infant subgroups.
- The incidence of cicatricial ROP was similar between the two groups.
Abstract:
To determine whether the use of continuous transcutaneous oxygen monitoring (tcPO2) could reduce the incidence of retinopathy of prematurity (ROP) in pre-term infants receiving oxygen therapy, a randomized, prospective trial of constant monitoring using the transcutaneous oxygen monitor versus intermittent monitoring of oxygen was performed on a population of premature infants at very high risk for the development of ROP. Two hundred ninety-six infants were randomly assigned to either a constantly monitored (CM) or standard care (SC) group. CM infants had tcPO2 monitored continuously as long as they required supplemental oxygen, whereas SC infants had tcPO2 monitored only during the more acute state of their illness. Management of both groups was otherwise identical. One hundred one of 148 infants in the CM group and 113 of 148 in the SC group survived. The overall incidence of ROP was 51% in the CM group and 59% in the SC group (no significant difference). In infants over 1000 g birthweight, as the weight increased there was increasing risk of developing ROP in the SC group. The odds ratio for the ROPsc:ROPcm reached 7.6 in infants between 1200 and 1300 g in infants with Apgar scores greater than or equal to 8 at 5 minutes. The incidence of cicatricial ROP was similar in both groups: four in the CM and five in the SC group.