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Am J Perinatol. 2015 Sep;32(11):1024-30. doi: 10.1055/s-0035-1547321. Epub 2015 Mar 31.

Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants.

Author information

1
Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
2
Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
3
Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
4
Statistics and Epidemiology Unit, RTI International, Rockville, Maryland.
5
Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina.
6
Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia.
7
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
8
Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island.
9
Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas.
10
Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
11
Department of Pediatrics, University of Iowa, Iowa City, Iowa.
12
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children&s Hospital, Palo Alto, California.
13
Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts.
14
Department of Pediatrics, Duke University, Durham, North Carolina.
15
Department of Pediatrics, Wayne State University, Detroit, Michigan.
16
Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama.
17
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
18
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
19
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, Maryland.

Abstract

BACKGROUND:

We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants.

OBJECTIVE:

This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death.

STUDY DESIGN:

The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed.

RESULTS:

All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death.

CONCLUSIONS:

The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

PMID:
25825962
PMCID:
PMC4689139
DOI:
10.1055/s-0035-1547321
[Indexed for MEDLINE]
Free PMC Article

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