Single Arterial Oxygen Tension Elevation Increases the Risk of Stage of Acute Disease Retinopathy of Prematurity

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IJRETINA Vol 6 No 2
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Published Sep 27, 2023
DOI: https://doi.org/10.35479/ijretina.2023.vol006.iss002.242

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Karina Satyani Pratiwi
MD
Dian Estu Yulia Julie Dewi Barliana Rita Sita Sitorus

Abstract

Introduction: Numerous studies have shown inconclusive results regarding ideal parameter for oxygen supplementation to balance the risk of mortality and retinopathy of prematurity (ROP) development. The purpose of this study is to compare mean partial oxygen tension (PaO2) level in ROP.


Methods: This retrospective study was performed on premature infants undergoing ROP screening at our neonatal intensive care unit during 2021. All infants born at our hospital at ≤ 30 weeks, birth weight (BW) ≤ 1500 grams, or high-risk infants with prolonged ventilation were included. ROP screening was performed at chronological age four to six weeks, were followed and managed according to the severity. ROP severity was categorized by International Classification of ROP 3rd edition (ICROP3). We reviewed the characteristics of each group and compared mean PaO2 level in day 1, day 5, and day 10 between incomplete vascularization (IV) group, stage of acute disease (SAD) group, and Aggressive ROP (A-ROP) group.


Result: We investigated 124 eyes from 62 eligible PI. The incidence of IV, stage 1, stage 2, stage 3, and A-ROP were 58.9%, 2.4%, 7.3%, 23.4%, and 8.1%, respectively. Mean PaO2 level in day 5 was higher in SAD group compared to IV group (p=0.002). For each level increase in PaO2, there was 1.042 times higher odds of developing SAD (p=0.004). Multivariate logistic regression analysis showed consistent results, simultaneously, each week increase in GA was associated with lower risk of SAD development (p=0.018) and each level increase in PaO2 was associated with higher risk for SAD development (p=0.005).


Conclusion: A single elevation in PaO2 during early life of PI increases the risk of developing stage of acute disease ROP, particularly in younger infants. Careful monitoring for PaO2 is mandatory to prevent development of ROP.

Keywords

Retinopathy of prematurity, Neonatal care, Partial oxygen tension

Article Details

How to Cite
PRATIWI, Karina Satyani et al. Single Arterial Oxygen Tension Elevation Increases the Risk of Stage of Acute Disease Retinopathy of Prematurity. International Journal of Retina, [S.l.], v. 6, n. 2, p. 82, sep. 2023. ISSN 2614-8536. Available at: <https://ijretina.com/index.php/ijretina/article/view/242>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.35479/ijretina.2023.vol006.iss002.242.
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Issue
Vol 6 No 2 (2023): International Journal of Retina (IJRetina) - INAVRS
Section
Research Articles
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References

REFERENCES

1. Caberry WY, Popovic MM, Dhoot AS, Arjmand P, Muni RH, Tehrani NN, et al. Demographic Risk Factors of Retinopathy of Prematurity: A Systematic Review of Population-Based Studies. Neonatology. 2022:1-13.
2. Freitas AM, Mörschbächer R, Thorell MR, Rhoden EL. Incidence and risk factors for retinopathy of prematurity: a retrospective cohort study. International journal of retina and vitreous. 2018;4(1):1-8.
3. Siswanto E, Sauer PJ. Retinopathy of prematurity in Indonesia: incidence and risk factors. Journal of neonatal-perinatal medicine. 2017;10(1):85-90.
4. Prakalapakorn SG, Edwards EM, Greenberg L, Ehret D. Trends in retinopathy of prematurity screening, incidence, severity, and treatment in the United States, the Vermont Oxford Network experience from 2008-2018. Journal of American Association for Pediatric Ophthalmology and Strabismus {JAAPOS}. 2021;25(4):e66-e7.
5. Cudjoe G, Ameley A, Ohemeng-Dapaah J, Bhatt P, Donda K, Dapaah-Siakwan F. National trends in the incidence and management of retinopathy of prematurity in the United States, 2009–2018. Journal of Neonatal-Perinatal Medicine. 2022(Preprint):1-5.
6. Hamad AE, Moinuddin O, Blair MP, Schechet SA, Shapiro MJ, Quiram PA, et al. Late-onset retinal findings and complications in untreated retinopathy of prematurity. Ophthalmology Retina. 2020;4(6):602-12.
7. Martin A, Faes C, Debevec T, Rytz C, Millet G, Pialoux V. Preterm birth and oxidative stress: Effects of acute physical exercise and hypoxia physiological responses. Redox biology. 2018;17:315-22.
8. SUPPORT. Target ranges of oxygen saturation in extremely preterm infants. New England Journal of Medicine. 2010;362(21):1959-69.
9. Choo MM, Grigg J, Barnes EH, Khaliddin N, Kamalden TA, Kamar AA, et al. Comparative cohorts of retinopathy of prematurity outcomes of differing oxygen saturation: real-world outcomes. BMJ open ophthalmology. 2021;6(1):e000626.
10. Mathias M, Chang J, Perez M, Saugstad O. Supplemental oxygen in the newborn: historical perspective and current trends. Antioxidants. 2021;10(12):1879.
11. Hartnett ME, Lane RH. Effects of oxygen on the development and severity of retinopathy of prematurity. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2013;17(3):229-34.
12. Hartnett ME, Penn JS. Mechanisms and management of retinopathy of prematurity. New England Journal of Medicine. 2012;367(26):2515-26.
13. Dai C, Webster KA, Bhatt A, Tian H, Su G, Li W. Concurrent physiological and pathological angiogenesis in retinopathy of prematurity and emerging therapies. International journal of molecular sciences. 2021;22(9):4809.
14. Hartnett ME. Pathophysiology and mechanisms of severe retinopathy of prematurity. Ophthalmology. 2015;122(1):200-10.
15. Chan-Ling T, Gole GA, Quinn GE, Adamson SJ, Darlow BA. Pathophysiology, screening and treatment of ROP: a multi-disciplinary perspective. Progress in retinal and eye research. 2018;62:77-119.
16. Hauspurg AK, Allred EN, Vanderveen DK, Chen M, Bednarek FJ, Cole C, et al. Blood gases and retinopathy of prematurity: the ELGAN Study. Neonatology. 2011;99(2):104-11.
17. York JR, Landers S, Kirby RS, Arbogast PG, Penn JS. Arterial oxygen fluctuation and retinopathy of prematurity in very-low-birth-weight infants. Journal of perinatology. 2004;24(2):82-7.
18. Chiang MF, Quinn GE, Fielder AR, Ostmo SR, Chan RP, Berrocal A, et al. International classification of retinopathy of prematurity. Ophthalmology. 2021;128(10):e51-e68.
19. Ying G-S, Bell EF, Donohue P, Tomlinson LA, Binenbaum G, Group G-RR. Perinatal risk factors for the retinopathy of prematurity in postnatal growth and ROP study. Ophthalmic epidemiology. 2019;26(4):270-8.
20. Higgins RD. Oxygen saturation and retinopathy of prematurity. Clinics in Perinatology. 2019;46(3):593-9.
21. Hughes S, Yang H, Chan-Ling T. Vascularization of the human fetal retina: roles of vasculogenesis and angiogenesis. Investigative ophthalmology & visual science. 2000;41(5):1217-28.
22. Graziosi A, Perrotta M, Russo D, Gasparroni G, D’Egidio C, Marinelli B, et al. Oxidative stress markers and the retinopathy of prematurity. Journal of Clinical Medicine. 2020;9(9):2711.
23. Joyal J-S, Gantner ML, Smith LE. Retinal energy demands control vascular supply of the retina in development and disease: The role of neuronal lipid and glucose metabolism. Progress in retinal and eye research. 2018;64:131-56.
24. Tsang JK, Liu J, Lo AC. Vascular and neuronal protection in the developing retina: potential therapeutic targets for retinopathy of prematurity. International journal of molecular sciences. 2019;20(17):4321.
25. Imanishi Y, Hirata K, Nozaki M, Mochizuki N, Hirano S, Fukushima Y, et al. Effect of fluctuation of oxygenation on the development of severe retinopathy of prematurity in extremely preterm infants. Journal of Perinatology. 2020;40(3):515-21.
26. Selvam S, Kumar T, Fruttiger M. Retinal vasculature development in health and disease. Progress in retinal and eye research. 2018;63:1-19.
27. Gonzalez-Fernandez F. Development of the Retina. Pediatric Retina: Springer; 2011. p. 1-37.
28. Collins J-A, Rudenski A, Gibson J, Howard L, O’Driscoll R. Relating oxygen partial pressure, saturation and content: the haemoglobin–oxygen dissociation curve. Breathe. 2015;11(3):194-201.
29. Duscio E, Vasques F, Romitti F, Cipulli F, Gattinoni L. Oxygen Delivery. Hemodynamic Monitoring. 2019:81-96.
30. Owen LA, Hartnett ME. Current concepts of oxygen management in retinopathy of prematurity. Journal of Ophthalmic & Vision Research. 2014;9(1):94.
31. Colaizy TT, Longmuir S, Gertsch K, Abramoff MD, Klein JM. Use of a supplemental oxygen protocol to suppress progression of retinopathy of prematurity. Investigative ophthalmology & visual science. 2017;58(2):887-91.
32. Chen ML, Guo L, Smith LE, Dammann CE, Dammann O. High or low oxygen saturation and severe retinopathy of prematurity: a meta-analysis. Pediatrics. 2010;125(6):e1483-e92.
33. Di Fiore JM, Kaffashi F, Loparo K, Sattar A, Schluchter M, Foglyano R, et al. The relationship between patterns of intermittent hypoxia and retinopathy of prematurity in preterm infants. Pediatric research. 2012;72(6):606-12.