Retinopathy of prematurity. Risk factors in a five-year cohort of critically ill premature neonates
D. R. Brown, J. R. Milley, U. J. Ripepi and A. W. Biglan
We studied the importance of exposure to an elevated partial pressure of
carbon dioxide (PCO2) in the development of scarring retinopathy of
prematurity (SROP) in a cohort of 92 neonates with chronic lung disease
(greater than or equal to 14 days of respiratory therapy, greater than or
equal to 30 days of oxygen therapy, and greater than or equal to 70 days in
the hospital), 31 of whom had SROP. This cohort was chosen to avoid
confounding prolonged respiratory failure with the presence of SROP and
because such a cohort was expected to contain approximately 85% of all
patients with SROP. Patients with SROP had a lower PCO2 and spent more time
on a respirator at higher respirator pressures during the first 70 days of
life. In addition, infants with SROP had a lower mean arterial pressure and
had a higher prevalence of seizures (97% vs 43%) and intraventricular
hemorrhage (52% vs 26%). We conclude that an elevated PCO2 is not
associated with SROP in this group of critically ill premature neonates but
that the presence of a seizure disorder or an intraventricular hemorrhage
is strongly associated with SROP.
