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J Pediatr. 2012 Feb;160(2):239-244.e2. doi: 10.1016/j.jpeds.2011.07.041. Epub 2011 Sep 17.

Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation.

Collaborators (213)

Jobe AH, Oh W, Cashore B, Gargus RA, Moore JR, Stephens BE, Walden RV, Alksninis B, Hensman AM, Lainwala S, Leach TM, Leonard MR, Noel L, Watson VE, Stark AR, Dow S, Driscoll C, Fournier K, Lee KG, Fanaroff AA, Wilson-Costello DE, Newman NS, Friedman HG, Siner BS, Schibler K, Donovan EF, Bridges K, Steichen JJ, Yolton K, Alexander B, Gratton TL, Grisby C, Hessling J, Mincey HL, Mersmann MW, Goldberg RN, Cotten C, Goldstein RF, Auten KJ, Gustafson KE, Lohmeyer MB, Stoll BJ, Jain L, Adams-Chapman I, Blackwelder AM, Carter S, Hale EC, LaRossa MM, Smikle GV, Higgins RD, Wright LL, McClure EM, Poindexter BB, Lemons JA, Dusick AM, Appel DD, Bohnke LG, Bull M, Cook AB, Eaken G, Herron DE, Kardatzke D, Lytle C, Miller LC, Minnich HM, Richard L, Wilson LD, Das A, Poole W, Hastings BK, McClure EM, Newman JE, Auman JO, Huitema CP, Schaefer SE, Zaterka-Baxter KM, Stevenson DK, Ahlfors CE, Fleisher BE, Hajdena-Dawson M, Hintz SR, Ball M, Stebbins RD, Baran JM, Bond LE, Brudos GK, DeBattista AM, Kohn JG, Lee-Ancajas JC, Pyle RP, John NH, Carlo WA, Bailey KJ, Biasini FJ, Collins MV, Chopko SA, Cosby SS, Moses MB, Nelson KG, Peralta-Carcelen M, Phillips VA, Preskitt J, Rector RV, Whitley S, Finer NN, Wozniak PR, Rasmussen MR, Vaucher YE, Fuller MG, Arnell K, Barbieri-Welge R, Ben-Tall A, Bridge R, Demetrio C, Henderson C, Ito E, Lukasik M, Pontillo D, Posin D, Rich W, Runyan C, Wilkes J, Bauer CR, Duara S, Calejo M, Diaz AN, Everett-Thomas R, FradeEguaras SM, Gideon YC, Hiriart-Fajardo S, Worth AM, Stroerger A, Papile LA, Lacy C, Laadt G, Long DV, Lowe J, Montman R, Phelps DL, Myers GJ, Reubens LJ, Johnson JB, Hust D, Jensen RL, Kushner E, Merzbach J, Rowan M, Yost K, Zwetsch L, Korones SB, Bada HS, Hudson T, Williams M, Yolton K, Sánchez PJ, Rosenfeld CR, Salhab WA, Tyson JE, Broyles R, Heyne RJ, Adams SS, Dooley C, Guzman A, Hensley G, Hickman JF, Heyne E, Lupino C, Madden LA, Madison S, Miller NA, Morgan JS, Boatman CT, Kennedy KA, Tyson JE, Bradt PJ, Major-Kincade T, Morris BH, Whitely LL, Akpa EG, Alaniz NI, Cedillo M, Orekoya PA, Dieterich S, Franco CI, Lis AE, McDavid GE, Tate PP, O'Shea T, Dillard RG, Washburn LK, Welch CD, Allred DE, Goldstein DJ, Jackson BG, Peters NJ, Peterson C, Waldrep EL, Morris MW, Hounshell GW, Shankaran S, Delaney-Black V, Johnson YR, Bara R, Muran G, Kennedy D, Driscoll D, Goldston L, Ehrenkranz RA, Gettner P, Konstantino M, Mayes L, Poulsen J, Romano E.

Author information

  • 1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA. myra.wyckoff@utsouthwestern.edu

Abstract

OBJECTIVE:

To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants.

STUDY DESIGN:

We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs.

RESULTS:

Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, P<.0001) and gestational age (25±2 weeks versus 26±2 weeks, P<.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI.

CONCLUSIONS:

DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.

Copyright © 2012 Mosby, Inc. All rights reserved.

PMID:
21930284
[PubMed - indexed for MEDLINE]
PMCID:
PMC3258355
Free PMC Article

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