Madden Janet E, Bobola Deborah L
Newborn Intensive Care Unit, Massachusetts General Hospital for Children, Boston, MA 02114, USA.
Adv Neonatal Care. 2010 Aug;10(4):182-7. doi: 10.1097/ANC.0b013e3181e94176.
Retinopathy of prematurity (ROP) is a common disease of premature infants. It is characterized by an abnormal proliferation of blood vessels in the developing retina and is the leading cause of childhood blindness in developed countries. This article describes a systematic approach to prospectively reduce the incidence of ROP in a newborn intensive care unit (NICU). We realized the need for improvement when we reviewed comparative data indicating that our rates of ROP were higher than those in NICUs in our local area, across the United States, and around the world. After informal efforts appeared successful in significantly reducing ROP, we designed and implemented a more structured approach to ROP prevention that included improvements in practice related to oxygen administration and monitoring. An evidence-based guideline was developed, and education was provided to all direct care providers. We also standardized bedside oxygen delivery equipment and implemented new parameters related to nasal cannula weaning. Rates of ROP, severe ROP, and ROP requiring surgical intervention were reduced by more than 50% during the first year and more than 75% by the end of the second year after implementation of our unit-based program.
早产儿视网膜病变（ROP）是一种常见的早产儿疾病。其特征是发育中的视网膜血管异常增生，是发达国家儿童失明的主要原因。本文描述了一种前瞻性降低新生儿重症监护病房（NICU）中ROP发病率的系统方法。当我们审查比较数据时，意识到有改进的必要，这些数据表明我们的ROP发病率高于当地、美国及全球其他NICU。在非正式努力似乎成功显著降低ROP后，我们设计并实施了一种更结构化的ROP预防方法，包括改进与氧气管理和监测相关的实践。制定了基于证据的指南，并向所有直接护理人员提供教育。我们还规范了床边氧气输送设备，并实施了与鼻导管撤机相关的新参数。在实施我们基于病房的项目后的第一年，ROP、严重ROP以及需要手术干预的ROP发病率降低了50%以上，到第二年年底降低了75%以上。
