PMID- 30763441
OWN - NLM
STAT- MEDLINE
DCOM- 20200213
LR  - 20220408
IS  - 2168-6173 (Electronic)
IS  - 2168-6165 (Print)
IS  - 2168-6165 (Linking)
VI  - 137
IP  - 4
DP  - 2019 Apr 1
TI  - Comparison of Biphasic vs Static Oxygen Saturation Targets Among Infants With 
      Retinopathy of Prematurity.
PG  - 417-423
LID - 10.1001/jamaophthalmol.2018.7021 [doi]
AB  - IMPORTANCE: The Surfactant, Positive Pressure, and Pulse Oximetry Randomized 
      Trial (SUPPORT) demonstrated that static low oxygen saturation decreased 
      retinopathy of prematurity (ROP) but increased mortality compared with static 
      high oxygen saturation cohorts. OBJECTIVE: To compare outcomes of a biphasic 
      oxygen protocol with static targets recommended by SUPPORT. DESIGN, SETTING, AND 
      PARTICIPANTS: Retrospective cohort study comparing biphasic vs static standards 
      41 months prior to and 42 months after a change from biphasic to static SUPPORT 
      standards at a level III neonatal intensive care unit (Fairview Hospital, 
      Cleveland, Ohio). The study included infants born at a corrected gestational age 
      (CGA) of 31 weeks or younger or birth weight 1500 g or less. Data were analyzed 
      between August 2010 and July 2017. INTERVENTIONS: The pre-SUPPORT group underwent 
      biphasic protocol target saturations of 85% to 92% at younger than 34 weeks' CGA 
      and greater than 95% at 34 weeks' CGA or older. The post-SUPPORT group underwent 
      a constant 91% to 95% target. MAIN OUTCOMES AND MEASURES: Primary outcome was 
      incidence of type 1 ROP. Secondary outcomes were incidence of any ROP, time to 
      full vascularization, and mortality. RESULTS: Of 596 eligible infants, 562 were 
      included in ophthalmic analysis. Three hundred three patients were boys (54%); 
      399 were white (71%), 87 were black (15%), and 76 were of other or unknown 
      race/ethnicity (14%). Mean (SD) CGA and birth weight were 29 (2) weeks and 1151 
      (346) g, respectively. Any ROP overall increased (53 [20%] pre-SUPPORT vs n = 86 
      [28%] post-SUPPORT; absolute difference, 8%; 95% CI, 1%-15%; odds ratio, 1.6; 95% 
      CI, 1.05-2.3; P = .03). Type 1 ROP increased in the post-SUPPORT era (n = 6 [2%] 
      pre-SUPPORT vs n = 18 [6%] post-SUPPORT; absolute difference, 4%; 95% CI, 
      0.4%-7%; odds ratio, 2.7; 95% CI, 1.05-6.9; P = .03). There was a delay in 
      vascularization in the post-SUPPORT group (n = 6 [2%] pre-SUPPORT vs n = 18 [6%] 
      post-SUPPORT; absolute difference, 4%; 95% CI, 0.4%-7%; P = .03). CONCLUSIONS AND 
      RELEVANCE: Compared with static oxygen standards, biphasic oxygen targets are 
      associated with decreased incidence and severity of ROP without increasing 
      mortality.
FAU - Shukla, Ankita
AU  - Shukla A
AD  - Department of Pediatrics, Division of Neonatology, Cleveland Clinic, Cleveland, 
      Ohio.
AD  - Department of Pediatrics, Case Western Reserve Institute-Metro Health Medical 
      Center, Cleveland, Ohio.
FAU - Sonnie, Christine
AU  - Sonnie C
AD  - Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Worley, Sarah
AU  - Worley S
AD  - Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
FAU - Sharma, Amit
AU  - Sharma A
AD  - Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Howard, Dawn
AU  - Howard D
AD  - Department of Pediatrics, Division of Neonatology, Cleveland Clinic, Cleveland, 
      Ohio.
FAU - Moore, Jon
AU  - Moore J
AD  - Department of Pediatrics, Case Western Reserve Institute-Metro Health Medical 
      Center, Cleveland, Ohio.
FAU - Rodriguez, Ricardo J
AU  - Rodriguez RJ
AD  - Department of Pediatrics, Division of Neonatology, Cleveland Clinic, Cleveland, 
      Ohio.
FAU - Hoppe, George
AU  - Hoppe G
AD  - Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Sears, Jonathan E
AU  - Sears JE
AD  - Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
AD  - Cellular and Molecular Medicine, Cleveland Clinic, Cleveland, Ohio.
LA  - eng
GR  - R01 EY024972/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA Ophthalmol
JT  - JAMA ophthalmology
JID - 101589539
SB  - IM
CIN - JAMA Ophthalmol. 2019 Apr 1;137(4):423-424. PMID: 30763437
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Infant, Newborn
MH  - Infant, Very Low Birth Weight
MH  - Male
MH  - Odds Ratio
MH  - Oxygen Consumption/physiology
MH  - Oxygen Inhalation Therapy/*methods
MH  - *Retinopathy of Prematurity/epidemiology/physiopathology/therapy
MH  - Retrospective Studies
PMC - PMC6459099
COIS- Conflict of Interest Disclosures: None reported.
EDAT- 2019/02/15 06:00
MHDA- 2020/02/14 06:00
PMCR- 2020/02/14
CRDT- 2019/02/15 06:00
PHST- 2019/02/15 06:00 [pubmed]
PHST- 2020/02/14 06:00 [medline]
PHST- 2019/02/15 06:00 [entrez]
PHST- 2020/02/14 00:00 [pmc-release]
AID - 2723994 [pii]
AID - eoi180118 [pii]
AID - 10.1001/jamaophthalmol.2018.7021 [doi]
PST - ppublish
SO  - JAMA Ophthalmol. 2019 Apr 1;137(4):417-423. doi: 
      10.1001/jamaophthalmol.2018.7021.