Early versus late discontinuation of oxygen in preterm or low birth weight infants
Background It has been hypothesized that the duration of supplemental oxygen administration, independent of the oxygen concentration, gestational age and/or birth weight, is influential in the development of severe retinopathy of prematurity (ROP). Concern regarding the possible deleterious effects...
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| Veröffentlicht in: | Cochrane database of systematic reviews 2001, Vol.2010 (1), p.CD001076-CD001076 |
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| creator | Askie, Lisa M Henderson‐Smart, David J Askie, Lisa M |
| description | Background
It has been hypothesized that the duration of supplemental oxygen administration, independent of the oxygen concentration, gestational age and/or birth weight, is influential in the development of severe retinopathy of prematurity (ROP). Concern regarding the possible deleterious effects of prolonged oxygen supplementation has lead many clinicians to wean infants from oxygen therapy as early as possible. However, recent work in feline models has suggested that visual outcomes may be improved by continuing oxygen supplementation during the recovery phase of ROP. The effect of duration of oxygen supplementation on the long‐term growth and development of preterm or low birth weight infants remains unclear.
Objectives
To determine the effect of early versus late weaning from supplementary oxygen on mortality, retinopathy of prematurity, lung function, growth or development in preterm or low birth weight infants.
Search methods
The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, s, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. An additional literature search of the MEDLINE and CINAHL databases was conducted in order to locate any trials in addition to those provided by the Cochrane Controlled Trials Register (CENTRAL/CCTR).
Selection criteria
All trials utilising random or quasi‐random patient allocation in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants were eligible for inclusion.
Data collection and analysis
The degree of selection, performance, attrition and detection bias was assessed independently by each review author. Data regarding clinical outcomes including mortality, retinopathy of prematurity, and long‐term growth and development were extracted and reviewed independently by each review author. Results were compared and differences resolved as required. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.
Main results
In the single eligible trial of 99 infants with birth weights less than 1650 g, there were no significant differences in neonatal death rates or retrolental fibroplasia (any grade or severe) for all infants, or among infants with birth weights of less than 1000 g. No other outcome measures specified a priori as cli |
| doi_str_mv | 10.1002/14651858.CD001076 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8406905</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72248397</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4296-958c5d8e356d9c3de62b3814c760ea2fa3048dbcbe6ef9059d409fb023d45b4e3</originalsourceid><addsrcrecordid>eNp1kctOAyEUhonRWG8P4MawcleFGYaBjYmp18TExOiaMMyZFjOFCkxr395pWrUuXEHO-c93Lj9Cp5RcUEKyS8p4QUUhLkY3hFBS8h10sIoNV8Hdrf8AHcb4TkjOZVbuowGlXJREFgfo5VaHdonnEGIXcasT4NpG412yrtPJeod9g_3ncgwOW4dnARKEKfYBt36BKxvSBC_AjiepTzfapXiM9hrdRjjZvEfo7e72dfQwfHq-fxxdPw0NyyQfykKYohaQF7yWJq-BZ1UuKDMlJ6CzRueEiboyFXBoJClkzYhsKpLlNSsqBvkRulpzZ101hdqAS0G3ahbsVIel8tqqvxlnJ2rs50owwntgDzjfAIL_6CAmNe1Xh7bVDnwXVZllTOSy7IV0LTTBxxig-WlCiVo5ob6dUN9O9DVn29P9VmxO3wvEWrCwLSyV8WYS-sb_I3_ZX89SlgQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72248397</pqid></control><display><type>article</type><title>Early versus late discontinuation of oxygen in preterm or low birth weight infants</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Askie, Lisa M ; Henderson‐Smart, David J ; Askie, Lisa M</creator><creatorcontrib>Askie, Lisa M ; Henderson‐Smart, David J ; Askie, Lisa M</creatorcontrib><description>Background
It has been hypothesized that the duration of supplemental oxygen administration, independent of the oxygen concentration, gestational age and/or birth weight, is influential in the development of severe retinopathy of prematurity (ROP). Concern regarding the possible deleterious effects of prolonged oxygen supplementation has lead many clinicians to wean infants from oxygen therapy as early as possible. However, recent work in feline models has suggested that visual outcomes may be improved by continuing oxygen supplementation during the recovery phase of ROP. The effect of duration of oxygen supplementation on the long‐term growth and development of preterm or low birth weight infants remains unclear.
Objectives
To determine the effect of early versus late weaning from supplementary oxygen on mortality, retinopathy of prematurity, lung function, growth or development in preterm or low birth weight infants.
Search methods
The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, s, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. An additional literature search of the MEDLINE and CINAHL databases was conducted in order to locate any trials in addition to those provided by the Cochrane Controlled Trials Register (CENTRAL/CCTR).
Selection criteria
All trials utilising random or quasi‐random patient allocation in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants were eligible for inclusion.
Data collection and analysis
The degree of selection, performance, attrition and detection bias was assessed independently by each review author. Data regarding clinical outcomes including mortality, retinopathy of prematurity, and long‐term growth and development were extracted and reviewed independently by each review author. Results were compared and differences resolved as required. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.
Main results
In the single eligible trial of 99 infants with birth weights less than 1650 g, there were no significant differences in neonatal death rates or retrolental fibroplasia (any grade or severe) for all infants, or among infants with birth weights of less than 1000 g. No other outcome measures specified a priori as clinically meaningful were reported in enough detail or with satisfactory follow‐up rates to include in the analysis (early death, chronic lung disease, long‐term growth, development, lung or visual function).
Authors' conclusions
The results of this systematic review do not provide strong evidence for either the benefits or harms of early oxygen weaning in preterm/LBW infants. Future research should be directed toward addressing the question of what are the most appropriate target levels of oxygenation, in both the early and late neonatal periods, rather than whether oxygen should be weaned early or late.</description><identifier>ISSN: 1465-1858</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD001076</identifier><identifier>PMID: 11687095</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Child health ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Infant, Premature, Diseases - therapy ; Medicine General & Introductory Medical Sciences ; Neonatal care ; Oxygen ; Oxygen - administration & dosage ; Oxygen administration ; Oxygen Inhalation Therapy ; Randomized Controlled Trials as Topic ; Respiratory Disorders ; Respiratory Insufficiency ; Respiratory Insufficiency - therapy ; Risk ; Ventilator Weaning</subject><ispartof>Cochrane database of systematic reviews, 2001, Vol.2010 (1), p.CD001076-CD001076</ispartof><rights>Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4296-958c5d8e356d9c3de62b3814c760ea2fa3048dbcbe6ef9059d409fb023d45b4e3</citedby><cites>FETCH-LOGICAL-c4296-958c5d8e356d9c3de62b3814c760ea2fa3048dbcbe6ef9059d409fb023d45b4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4022,27922,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11687095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Askie, Lisa M</creatorcontrib><creatorcontrib>Henderson‐Smart, David J</creatorcontrib><creatorcontrib>Askie, Lisa M</creatorcontrib><title>Early versus late discontinuation of oxygen in preterm or low birth weight infants</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
It has been hypothesized that the duration of supplemental oxygen administration, independent of the oxygen concentration, gestational age and/or birth weight, is influential in the development of severe retinopathy of prematurity (ROP). Concern regarding the possible deleterious effects of prolonged oxygen supplementation has lead many clinicians to wean infants from oxygen therapy as early as possible. However, recent work in feline models has suggested that visual outcomes may be improved by continuing oxygen supplementation during the recovery phase of ROP. The effect of duration of oxygen supplementation on the long‐term growth and development of preterm or low birth weight infants remains unclear.
Objectives
To determine the effect of early versus late weaning from supplementary oxygen on mortality, retinopathy of prematurity, lung function, growth or development in preterm or low birth weight infants.
Search methods
The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, s, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. An additional literature search of the MEDLINE and CINAHL databases was conducted in order to locate any trials in addition to those provided by the Cochrane Controlled Trials Register (CENTRAL/CCTR).
Selection criteria
All trials utilising random or quasi‐random patient allocation in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants were eligible for inclusion.
Data collection and analysis
The degree of selection, performance, attrition and detection bias was assessed independently by each review author. Data regarding clinical outcomes including mortality, retinopathy of prematurity, and long‐term growth and development were extracted and reviewed independently by each review author. Results were compared and differences resolved as required. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.
Main results
In the single eligible trial of 99 infants with birth weights less than 1650 g, there were no significant differences in neonatal death rates or retrolental fibroplasia (any grade or severe) for all infants, or among infants with birth weights of less than 1000 g. No other outcome measures specified a priori as clinically meaningful were reported in enough detail or with satisfactory follow‐up rates to include in the analysis (early death, chronic lung disease, long‐term growth, development, lung or visual function).
Authors' conclusions
The results of this systematic review do not provide strong evidence for either the benefits or harms of early oxygen weaning in preterm/LBW infants. Future research should be directed toward addressing the question of what are the most appropriate target levels of oxygenation, in both the early and late neonatal periods, rather than whether oxygen should be weaned early or late.</description><subject>Child health</subject><subject>Humans</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases</subject><subject>Infant, Premature, Diseases - therapy</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Neonatal care</subject><subject>Oxygen</subject><subject>Oxygen - administration & dosage</subject><subject>Oxygen administration</subject><subject>Oxygen Inhalation Therapy</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Respiratory Disorders</subject><subject>Respiratory Insufficiency</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Risk</subject><subject>Ventilator Weaning</subject><issn>1465-1858</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNp1kctOAyEUhonRWG8P4MawcleFGYaBjYmp18TExOiaMMyZFjOFCkxr395pWrUuXEHO-c93Lj9Cp5RcUEKyS8p4QUUhLkY3hFBS8h10sIoNV8Hdrf8AHcb4TkjOZVbuowGlXJREFgfo5VaHdonnEGIXcasT4NpG412yrtPJeod9g_3ncgwOW4dnARKEKfYBt36BKxvSBC_AjiepTzfapXiM9hrdRjjZvEfo7e72dfQwfHq-fxxdPw0NyyQfykKYohaQF7yWJq-BZ1UuKDMlJ6CzRueEiboyFXBoJClkzYhsKpLlNSsqBvkRulpzZ101hdqAS0G3ahbsVIel8tqqvxlnJ2rs50owwntgDzjfAIL_6CAmNe1Xh7bVDnwXVZllTOSy7IV0LTTBxxig-WlCiVo5ob6dUN9O9DVn29P9VmxO3wvEWrCwLSyV8WYS-sb_I3_ZX89SlgQ</recordid><startdate>2001</startdate><enddate>2001</enddate><creator>Askie, Lisa M</creator><creator>Henderson‐Smart, David J</creator><creator>Askie, Lisa M</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2001</creationdate><title>Early versus late discontinuation of oxygen in preterm or low birth weight infants</title><author>Askie, Lisa M ; Henderson‐Smart, David J ; Askie, Lisa M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4296-958c5d8e356d9c3de62b3814c760ea2fa3048dbcbe6ef9059d409fb023d45b4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Child health</topic><topic>Humans</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases</topic><topic>Infant, Premature, Diseases - therapy</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Neonatal care</topic><topic>Oxygen</topic><topic>Oxygen - administration & dosage</topic><topic>Oxygen administration</topic><topic>Oxygen Inhalation Therapy</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Respiratory Disorders</topic><topic>Respiratory Insufficiency</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Risk</topic><topic>Ventilator Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Askie, Lisa M</creatorcontrib><creatorcontrib>Henderson‐Smart, David J</creatorcontrib><creatorcontrib>Askie, Lisa M</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Askie, Lisa M</au><au>Henderson‐Smart, David J</au><au>Askie, Lisa M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early versus late discontinuation of oxygen in preterm or low birth weight infants</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2001</date><risdate>2001</risdate><volume>2010</volume><issue>1</issue><spage>CD001076</spage><epage>CD001076</epage><pages>CD001076-CD001076</pages><issn>1465-1858</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
It has been hypothesized that the duration of supplemental oxygen administration, independent of the oxygen concentration, gestational age and/or birth weight, is influential in the development of severe retinopathy of prematurity (ROP). Concern regarding the possible deleterious effects of prolonged oxygen supplementation has lead many clinicians to wean infants from oxygen therapy as early as possible. However, recent work in feline models has suggested that visual outcomes may be improved by continuing oxygen supplementation during the recovery phase of ROP. The effect of duration of oxygen supplementation on the long‐term growth and development of preterm or low birth weight infants remains unclear.
Objectives
To determine the effect of early versus late weaning from supplementary oxygen on mortality, retinopathy of prematurity, lung function, growth or development in preterm or low birth weight infants.
Search methods
The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, s, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. An additional literature search of the MEDLINE and CINAHL databases was conducted in order to locate any trials in addition to those provided by the Cochrane Controlled Trials Register (CENTRAL/CCTR).
Selection criteria
All trials utilising random or quasi‐random patient allocation in which early weaning was compared with late discontinuation of supplemental oxygen in preterm or low birth weight infants were eligible for inclusion.
Data collection and analysis
The degree of selection, performance, attrition and detection bias was assessed independently by each review author. Data regarding clinical outcomes including mortality, retinopathy of prematurity, and long‐term growth and development were extracted and reviewed independently by each review author. Results were compared and differences resolved as required. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.
Main results
In the single eligible trial of 99 infants with birth weights less than 1650 g, there were no significant differences in neonatal death rates or retrolental fibroplasia (any grade or severe) for all infants, or among infants with birth weights of less than 1000 g. No other outcome measures specified a priori as clinically meaningful were reported in enough detail or with satisfactory follow‐up rates to include in the analysis (early death, chronic lung disease, long‐term growth, development, lung or visual function).
Authors' conclusions
The results of this systematic review do not provide strong evidence for either the benefits or harms of early oxygen weaning in preterm/LBW infants. Future research should be directed toward addressing the question of what are the most appropriate target levels of oxygenation, in both the early and late neonatal periods, rather than whether oxygen should be weaned early or late.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>11687095</pmid><doi>10.1002/14651858.CD001076</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1465-1858 |
| ispartof | Cochrane database of systematic reviews, 2001, Vol.2010 (1), p.CD001076-CD001076 |
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| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Child health Humans Infant, Low Birth Weight Infant, Newborn Infant, Premature Infant, Premature, Diseases Infant, Premature, Diseases - therapy Medicine General & Introductory Medical Sciences Neonatal care Oxygen Oxygen - administration & dosage Oxygen administration Oxygen Inhalation Therapy Randomized Controlled Trials as Topic Respiratory Disorders Respiratory Insufficiency Respiratory Insufficiency - therapy Risk Ventilator Weaning |
| title | Early versus late discontinuation of oxygen in preterm or low birth weight infants |
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