Abstract
Surfactant administration in premature infants is supposed to induce rapid changes in tissue oxygenation. It might therefore modify the risk of developing retinopathy of prematurity (ROP). We have been using the so-called safety index
to calculate the number of infants at low risk to develop ROP stage 3 or higher (SI≥1) after administration of two preparations of a surfactant. The study population consisted of 255 prematures of ≤2000 g birth weight treated with surfactant for respiratory distress syndrome in Switzerland between 1991 and 1993. Of these infants, 29 received a natural surfactant (Curosurf), and 226 infants were treated with the synthetic surfactant Exosurf. Reduction of fraction inspired oxygen (FiO2) was significant within 3 and 6 h and was more pronounced in infants having received natural surfactant. An SI≥1 was calculated in 106 of the 226 infants (47%) treated with Exosurf. Only one of these infants developed ROP stage 3 in one eye (no ROP in the fellow eye) whereas 12 infants with ROP stages 3 or 4 had an SI<1. Seven of the 29 infants treated with natural surfactant had an SI≥1; none of these infants developed ROP>stage 2. According to this survey, the risk of developing severe stages of ROP does not increase in low birth weight infants who have been treated with surfactant. Irrespective of a surfactant therapy, the calculation of the SI is useful for substantially reducing the number of prematures who need intensive ophthalmological follow up.
Similar content being viewed by others
Abbreviations
- FiO 2 :
-
fraction inspired oxygen
- ROP :
-
retinopathy of prematurity
- SI :
-
safety index
References
Bossi E, Koerner F (1994) Prevalence of retinopathy of prematurity in Switzerland. Soz Präventivmed 39: 47–48
Bossi E, Koerner F (1995) Retinopathy of prematurity. Intensive Care Med 21: 241–246
Brown DR, Biglan AW, Stretavsky Marinda MA (1988) Screening criteria for the detection of retinopathy of prematurity in a neonatal intensive care unit. J Pediatr Ophthalmol Strabismus 24: 212–214
Clark DI, O'Brien C, Weindling AM, Saed M (1992) Initial experience of screening for retinopathy of prematurity. Arch Dis Child 67: 1233–1236
Committee for the Classification of Retinopathy of Prematurity (1984) An international classification of retinopathy of prematurity. Arch Ophthalmol 102: 1130–1134
Committee for the Classification of Retinopathy of Prematurity (1987) An international classification of retinopathy of prematurity. Arch Ophthalmol 105: 906–911
Cryotherapy for Retinopathy of Prematurity Cooperative Group (1988) Multicenter trial of cryotherapy for retinopathy of prematurity: preliminary results. Pediatrics 81: 697–706
Horbar JD, Wright LL, Soll RF, Wright EC, Fanaroff AA, Korones SB, Shankaran S, Oh W, Fletcher BD, Bauer CR, Tyson JE, Lemons JA, Donovan EF, Stoll BJ, Stevenson DD, Papile LA, Philips J (1993) A multicenter randomized trial comparing two surfactants for the treatment of neonatal respiratory distress syndrome. J Pediatr 123: 757–766
Javitt J, Dei Cas R, Chiang Y (1993) Cost-effectiveness of screening and cryotherapy for threshold retinopathy of prematurity. Pediatrics 91: 859–866
Koerner F, Bossi E (1984) Möglichkeiten der Voraussage des retinalen Risikos Frühgeborener. In Koerner F, Bossi E (eds) Die Retinopathie des Frühgeborenen. Gustav Fischer, Stuttgart, New York pp 65–77
Koerner F, Zulauf M, Bossi E (1982) Retinopathia praematurorum. Eine Studie über Verlauf, Prognose und Risikofaktoren. In: Metze H, Schaefer WD (eds) Retrolentale Fibroplasie. Ferdinand Enke, Stuttgart, pp 164–180
Koerner F, Bossi E, Meier-Gibbons F (1995) Selecting premature infants at low risk of ROP. Proceedings of the International Conference on ROP, Chicago 1993 (in press)
McGinnity FG, Girschek PK, Morin JD, O'Donoghue EP, Dunn MS (1994) Bovine surfactant therapy and retinopathy of prematurity. J Pediatr Ophthalmol Strabismus 31: 238–241
Meier-Gibbons F, Koerner F, Bossi E, Fauchère JC (1991) Aussagekraft des RPM-Sicherheitsindex bei der Retinopathia praematurorum. Klin Monatsbl Augenheilk 198: 487–488
The OSIRIS Collaborative Group (1992) Early versus delayed neonatal administration of a synthetic surfactant — the judgment of OSIRIS. Lancet 340: 1363–1369
Repka MX, Hardy RJ, Phelps DL, Summers CG (1993) Surfactant prophylaxis and retinopathy of prematurity. Arch Ophthalmol 111: 618–620
Strebel R, Bucher HU (1994) Bessere Ueberlebenschancen für extrem kleine Frühgeborene in der Schweiz. Schweiz Med Wochenschr 124: 1653–1659
Watts JL (1992) Retinopathy of prematurity. In: Sinclair JC, Bracken MB (eds) Effective care of the newborn infant. Oxford University Press, pp 617–639
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pietro, D.BD., Bossi, E. & Koerner, F. Screening for retinopathy of prematurity after surfactant treatment. Eur J Pediatr 154 (Suppl 4), S90–S94 (1995). https://doi.org/10.1007/BF02191515
Issue Date:
DOI: https://doi.org/10.1007/BF02191515