Effect of fluctuation of oxygenation and time spent in the target range on retinopathy of prematurity in extremely low birth weight infants

Das, A.*, Mhanna, M., Sears, J., Houdek, J.W., Kumar, N., Gunzler, D., Einstadter, D., Collin, M. | JNPM 2018;

BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSION: 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. 

*Corresponding Author: 

Anirudha Das, Cleveland Clinic Lerner College of Medicine affiliated with Case Western Reserve University, Department of Neonatology, Cleveland Clinic Children’s Hospital, Cleveland 44195, OH, USA. Tel.: +1 2162199767; E-mail: anirudhdas26@gmail.com.