Neonatal Unit, Simpson Centre for Reproductive Health, Edinburgh Royal Infirmary, Edinburgh, UK.
Neonatology. 2013;103(4):341-5. doi: 10.1159/000349936. Epub 2013 May 31.
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.
早产儿视网膜病变（ROP）在氧疗广泛应用于新生儿护理后不久就首次被观察到。早期试验表明，限制氧气补充可以减少 ROP 而没有其他后果，但当氧气限制变得广泛时，观察到死亡率增加。这些观察是在无法进行连续氧合监测的情况下进行的。现在，来自不同脉搏血氧饱和度（SpO2）目标范围的掩蔽随机对照试验的新试验证据表明，目标较低的 SpO2 水平可降低 ROP，但与死亡率显著增加相关。这些结果说明了随机试验的重要性，因为在最近的这些研究之前，基于观察数据的实践趋势有利于较低的 SpO2。随访数据可能会进一步为临床实践提供信息。
