Das A, Mhanna M, Sears J, Houdek J W, Kumar N, Gunzler D, Einstadter D, Collin M
Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
Department of Neonatology, MetroHealth Medical Center, Cleveland, OH, USA.
J Neonatal Perinatal Med. 2018;11(3):257-263. doi: 10.3233/NPM-1757.
The association between saturation of peripheral oxygenation (SpO2) fluctuation and severity of retinopathy of prematurity (ROP) is well elucidated in extremely low birth weight (ELBW) infants. Time spent in the Target range of SpO2 is also associated with the severity of ROP.
In a prospective observational study, the SpO2 of all ELBW infants admitted to our unit were monitored for the first four weeks of life, and averaged every minute for analysis. The percent time spent at SpO2 <90%, 90-95%, and >95% and weekly SpO2 fluctuations [as SpO2 coefficient of variation (CoV)] were calculated.
During the study period 21 infants had moderate to severe ROP and 35 infants served as controls. Infants with moderate to severe ROP were smaller and younger than their controls [676±124 grams vs. 796±148 grams (p < 0.001); and 24.0±1.0 weeks vs. 25.0±1.7 weeks (p < 0.001) respectively]. There were no significant differences in time spent in the 90-95% range between groups (p = 0.66). However there was a significant increase in weekly SpO2 CoV in infants with moderate to severe ROP vs. controls (p = 0.007).
In ELBW infants, there was an association between SpO2 fluctuation during the first four weeks of life and severity of ROP, although, no association was established with time spent in the target range of SpO2.
极低出生体重（ELBW）婴儿外周血氧饱和度（SpO2）波动与早产儿视网膜病变（ROP）严重程度之间的关联已得到充分阐明。SpO2处于目标范围内的时间也与ROP严重程度相关。
在一项前瞻性观察研究中，对入住我们科室的所有ELBW婴儿出生后前四周的SpO2进行监测，每分钟取平均值进行分析。计算SpO2<90%、90 - 95%和>95%时所花费的时间百分比以及每周的SpO2波动情况[以SpO2变异系数（CoV）表示]。
在研究期间，21例婴儿患有中度至重度ROP，35例婴儿作为对照。中度至重度ROP婴儿比其对照组更小、更年幼[分别为676±124克对796±148克（p<0.001）；24.0±1.0周对25.0±1.7周（p<0.001）]。两组之间在SpO2处于90 - 95%范围的时间上无显著差异（p = 0.66）。然而，中度至重度ROP婴儿的每周SpO2 CoV相较于对照组有显著增加（p = 0.007）。
在ELBW婴儿中，出生后前四周的SpO2波动与ROP严重程度之间存在关联，尽管未发现与SpO2目标范围内所花费的时间存在关联。
