J Pediatr. 2011 Oct;159(4):546-50.e1. doi: 10.1016/j.jpeds.2011.03.025. Epub 2011 May 17.
Impact of delivery room resuscitation on outcomes up to 18 months in very low birth weight infants.
Schmidt B, D'Ilario J, Cairnie J, Dix J, Adams B, Davis P, Doyle L, Faber B, Callanan K, Davis N, Duff J, Ford G, Asztalos E, Golec L, Lacy M, Hohn D, Haslam R, Barnett C, Goodchild L, Lontis R, Fraser S, Keng J, Saunders K, Opie G, Kelly E, Bairam A, Ferland S, Laperriere L, Bélanger S, St-Amand P, Blayney M, Davis D, Frank J, Lemyre B, Solimano A, Singh A, Chalmers M, Ramsay K, Synnes A, Whitfield M, Rogers M, Tomlinson J, Offringa M, Nuytemans D, Vermeulen E, Kok J, van Wassenaer A, Arnon S, Chalaf A, Regev R, Netter I, Ohlsson A, Nesbitt K, O'Brien K, Hamilton AM, Sankaran K, Morgan S, Proctor P, LaCorte M, LeBlanc P, Braithwaite A, Golan A, Barabi T, Goldstein E, Reynolds G, Dromgool B, Meskell S, McMillan D, Schaab D, Spellen L, Sauve R, Christianson H, Anseeuw-Deeks D, Alvaro R, Chiu A, Porter C, Turner G, Moddemann D, Granke N, Penner K, Mulder T, Ghys A, van der Hoeven M, Clarke M, Parfitt J, MacLean H, Nwaesei C, Kuhn L, Ryan H, Saunders C, Schulze A, Pudenz P, Muller M, Lagercrantz H, Bhiladvala M, Legnevall L, Herlenius E, Matthew D, Amos W, Tulsiani S, Tan-Dy C, Turner M, Shinwell E, Levine R, Juster-Reicher A, Barrington K, Kokkotis T, Khairy M, Grier P, Vachon J, Sinha S, Tin W, Fritz S, Walti H, Royer D, Halliday H, Millar D, Berry A, Mayes C, Cummings C, Fahnenstich H, Philipp K, Tillmann B, Weber P, Canning R, Wariyar U, Tin W, Fritz S, Embleton N, Bucher HU, Fauchere JC, Tin W, Fritz S, Pfister R, Launoy V, Huppi P, Poets C, Urschitz-Duprat P, Schmidt B, Barrington K, Davis P, Doyle LW, Ohlsson A, Roberts RS, Solimano A, Tin W, Gent M, Fraser W, Hey E, Perlman M, Thorpe K, Gray S, Roberts RS, Chambers C, Costantini L, McGean E, Scapinello L.
Source
Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA 19104, USA.
Abstract
OBJECTIVE:
To examine the relationships between intensity of delivery room resuscitation and short- and long-term outcomes of very low birth weight infants enrolled in the Caffeine for Apnea of Prematurity (CAP) Trial.
STUDY DESIGN:
The CAP Trial enrolled 2006 infants with birthweights between 500 and 1250 g who were eligible for caffeine therapy. All levels of delivery room resuscitation were recorded in study participants. We divided infants in 4 groups of increasing intensity of resuscitation: minimal, n = 343; bag-mask ventilation, n = 372; endotracheal intubation, n = 1205; and cardiopulmonary resuscitation (chest compressions/epinephrine), n = 86. We used multivariable logistic regression models to compare outcomes across the 4 groups.
RESULTS:
The observed rates of death or disability, death, cerebral palsy, cognitive deficit, and hearing loss at 18 months increased with higher levels of resuscitation. Risk of bronchopulmonary dysplasia, severe retinopathy of prematurity, and brain injury also increased with higher levels of resuscitation. Adjustment for prognostic variables reduced the differences between the groups for most outcomes. Only the adjusted rates of bronchopulmonary dysplasia and severe retinopathy remained significantly higher after more intense resuscitation.
CONCLUSIONS:
In CAP Trial participants, the risk of death or neurodevelopmental disability at 18 months did not increase substantially with increasing intensity of delivery room resuscitation.
Copyright © 2011 Mosby, Inc. All rights reserved.
- PMID:
- 21592510
- [PubMed - indexed for MEDLINE]
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