Low inspired oxygen concentrations in very-low-birthweight infants needing ventilatory support: an approach to the prevention of retrolental fibroplasia.

The level of arterial oxygen tension [Pa,o2] at which retrolental fibroplasia (RLF) may develop in very-low-birthweight infants is not known, but may be less than 100 mmHg (13.3 kPa). We report an infant of 27 weeks gestation who developed RLF despite continuous monitoring of Pa,o2 from 2 h to 4 weeks of age, with no recorded values above 95 mmHg (12.7 kPa). We therefore decided to maintain the Pa,o2 below 80 mmHg (10.7 kPa) in very-low-birthweight infants, using when necessary a low oxygen gas mixture (fractional inspired oxygen concentration 0.16-0.20). We report the use of this approach in four infants, all of whom survived without evidence of RLF. The need for further clinical studies of such an approach is discussed.