Emeritus Professor of Paediatrics, University of Otago, Christchurch, New Zealand.
Clinical Senior Lecturer and Honorary Consultant in Neonatal Medicine, Homerton University Hospital, London, UK.
Semin Perinatol. 2019 Oct;43(6):333-340. doi: 10.1053/j.semperi.2019.05.004. Epub 2019 May 10.
Reducing the burden of visual morbidity from retinopathy of prematurity (ROP) begins with primary prevention, and improvements in neonatal care with a positive impact on ROP are possible in all settings. Strategies range from rigorous adoption of inexpensive evidence-based protocols, for example on temperature control, prevention of sepsis and support for breast-milk feeding, through to comprehensive quality improvement programmes, and fostering team work and camaraderie. Oxygen monitoring is essential for very preterm infants receiving supplementary oxygen. The Neonatal Oxygenation Prospective Meta-analysis (NeOProM) collaboration has reported analysis of five trials of oxygen saturation (SpO) targeting in very preterm infants and shown that a SpO target of 85-89% compared to 91-95% was associated with increased mortality (on average 28 extra deaths for every 1000 infants treated). Adopting a SpO target higher than 85-89% might increase the risk of ROP for some infants, highlighting the importance of pursuing all other means of prevention.
降低早产儿视网膜病变（ROP）所致视觉发病率负担需要从一级预防开始，所有环境中都有可能通过改善新生儿护理来积极预防 ROP。策略范围从严格采用廉价的循证方案（例如，体温控制、预防败血症和支持母乳喂养）到全面的质量改进计划，以及促进团队合作和友谊。对于接受补充氧气的极早产儿，氧气监测至关重要。新生儿氧合前瞻性荟萃分析（NeOProM）合作组织报告了对五项极低出生体重儿氧饱和度（SpO2）目标试验的分析，结果表明，SpO2目标为 85-89%与 91-95%相比，死亡率增加（每 1000 名接受治疗的婴儿平均增加 28 例死亡）。采用高于 85-89%的 SpO2 目标可能会增加某些婴儿患 ROP 的风险，这突出表明需要寻求所有其他预防手段。
