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Variations in Oxygen Saturation Targeting, and Retinopathy of Prematurity Screening and Treatment Criteria in Neonatal Intensive Care Units: An International Survey
Univ Otago, Dept Paediat, Australian & New Zealand Neonatal Network, Christchurch, New Zealand.
Hlth Res Inst La Fe, Spanish Neonatal Network, Ave Fernando Abril Martorell, Valencia, Spain.ORCID iD: 0000-0003-0061-4742
McGill Univ, Montreal Childrens Hosp, Dept Pediat, Montreal, PQ, Canada.
Turku Univ Hosp, Dept Pediat, Finnish Med Birth Register, Turku, Finland;Turku Univ Hosp, Dept Pediat, Register Congenital Malformat, Turku, Finland.
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2018 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, Vol. 114, no 4, p. 323-331Article in journal (Refereed) Published
Abstract [en]

Background: Rates of retinopathy of prematurity (ROP) and ROP treatment vary between neonatal intensive care units (NICUs). Neonatal care practices, including oxygen saturation (SpO2) targets and criteria for the screening and treatment of ROP, are potential contributing factors to the variations. Objectives: To survey variations in SpO2 targets in 2015 (and whether there had been recent changes) and criteria for ROP screening and treatment across the networks of the International Network for Evaluating Outcomes in Neonates (iNeo). Methods: Online prepiloted questionnaires on treatment practices for preterm infants were sent to the directors of 390 NICUs in 10 collaborating iNeo networks. Nine questions were asked and the results were summarized and compared. Results: Overall, 329/390 (84%) NICUs responded, and a majority (60%) recently made changes in upper and lower SpO2 target limits, with the median set higher than previously by 2–3% in 8 of 10 networks. After the changes, fewer NICUs (15 vs. 28%) set an upper SpO2 target limit > 95% and fewer (3 vs. 5%) a lower limit < 85%. There were variations in ROP screening criteria, and only in the Swedish network did all NICUs follow a single guideline. The initial retinal examination was carried out by an ophthalmologist in all but 6 NICUs, and retinal photography was used in 20% but most commonly as an adjunct to indirect ophthalmoscopy. Conclusions: There is considerable variation in SpO2 targets and ROP screening and treatment criteria, both within networks and between countries.

Place, publisher, year, edition, pages
KARGER , 2018. Vol. 114, no 4, p. 323-331
Keywords [en]
Very preterm infants, Retinopathy of prematurity, Oxygen saturation targeting, Neonatal intensive care, Neonatal networks, Comparative analysis, Erythropoietin
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Pediatrics
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URN: urn:nbn:se:uu:diva-365997DOI: 10.1159/000490372ISI: 000445218800006PubMedID: 30089298OAI: oai:DiVA.org:uu-365997DiVA, id: diva2:1264615
Available from: 2018-11-20 Created: 2018-11-20 Last updated: 2018-11-20Bibliographically approved

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