Early blood pressure, antihypotensive therapy and outcomes at 18-22â
months' corrected age in extremely preterm infants.
Arch Dis Child Fetal Neonatal Ed
; 101(3): F201-6, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-26567120
ABSTRACT
OBJECTIVE:
To investigate the relationships between early blood pressure (BP) changes, receipt of antihypotensive therapy and 18-22â months' corrected age (CA) outcomes for extremely preterm infants.DESIGN:
Prospective observational study of infants 23(0/7)-26(6/7)â weeks' gestational age (GA). Hourly BP values and antihypotensive therapy exposure in the first 24â h were recorded. Four groups were defined infants who did or did not receive antihypotensive therapy in whom BP did or did not rise at the expected rate (defined as an increase in the mean arterial BP of ≥5â mmâ Hg/day). Random-intercept logistic modelling controlling for centre clustering, GA and illness severity was used to investigate the relationship between BP, antihypotensive therapies and infant outcomes.SETTING:
Sixteen academic centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. MAIN OUTCOMEMEASURES:
Death or neurodevelopmental impairment/developmental delay (NIDD) at 18-22â months' CA.RESULTS:
Of 367 infants, 203 (55%) received an antihypotensive therapy, 272 (74%) survived to discharge and 331 (90%) had a known outcome at 18-22â months' CA. With logistic regression, there was an increased risk of death/NIDD with antihypotensive therapy versus no treatment (OR 1.836, 95% CI 1.092 to 3.086), but not NIDD alone (OR 1.53, 95% CI 0.708 to 3.307).CONCLUSIONS:
Independent of early BP changes, antihypotensive therapy exposure was associated with an increased risk of death/NIDD at 18-22â months' CA when controlling for risk factors known to affect survival and neurodevelopment. CLINICAL TRIAL REGISTRATION NUMBER clinicaltrials.gov #NCT00874393.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Deficiências do Desenvolvimento
/
Mortalidade Infantil
/
Lactente Extremamente Prematuro
/
Hipotensão
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article