Prolonged respiratory support of any type impacts outcomes of extremely low birth weight infants.
Pediatr Pulmonol
; 53(10): 1447-1455, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30062831
ABSTRACT
OBJECTIVES:
This study tested the hypothesis that longer duration of any type of respiratory support is associated with an increased rate of death or neurodevelopmental impairment (NDI) at 18-22 months.METHODS:
Retrospective cohort study using the Generic Database of NICHD Neonatal Research Network from 2006 to 2010. Infants were born at <27 weeks gestational age with birth weights of 401-1000 g. Respiratory support received during initial hospitalization from birth was characterized as follows no support, only invasive support, only non-invasive support or mixed invasive, and non-invasive support. The primary outcome was death after 24 h of life or NDI at 18-22 months corrected age.RESULTS:
In a cohort of 3651 infants, 1494 (40.9%) died or had NDI. Cumulative respiratory support of any type beyond 60 days was associated with the likelihood of death or NDI. Infants who only received invasive support had the highest rate (89.1%), followed by those received mixed support (26.1%). Infants who received only non-invasive support had the lowest rate (7.7%). When compared to the only non-invasive support group, both invasive [OR 62.7 (95%CI 25.7, 152.6)] and mixed [OR 6.1 (95%CI 2.6, 14.4)] support groups were significantly more likely to die or have NDI.CONCLUSION:
Prolonged respiratory support, whether invasive or non-invasive, is associated with increased odds of a poor outcome. The proportion of infants with a poor outcome increased in a dose dependent manner by two factors the cumulative duration of respiratory support beyond 60 days, and the extent to which invasive support is provided.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Respiração Artificial
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Síndrome do Desconforto Respiratório do Recém-Nascido
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Deficiências do Desenvolvimento
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Recém-Nascido de Peso Extremamente Baixo ao Nascer
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
Pediatr Pulmonol
Assunto da revista:
PEDIATRIA
Ano de publicação:
2018
Tipo de documento:
Article