Cardiovascular Pharmacological Support Among Preterm Infants in Chinese Referral Center Neonatal Intensive Care Units

Luo, Ningxin; Jiang, Siyuan; Li, Xiaoying; Guo, Yan; Wang, Yang; Han, Junyan; Deng, Yingping; Yang, Yi; Lee, Shoo K.; Cao, Yun

doi:10.3389/fped.2021.638540

Cited by 3 publications

(3 citation statements)

References 43 publications

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“…Previous studies reported that the use of inotropes in preterm infants at an early age is associated with a higher risk of death, IVH, and BPD [ 16 – 18 ]. In particular, hypotension treatment in early life can reportedly affect changes in cerebral blood flow, causing IVH or hydrocephalus and long-term neurodevelopmental delays.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

et al. 2023

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Background Early extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short- and long-term outcomes. Therefore, the present study aimed to identify differences in risk factors and clinical outcomes between ES and EF in very early preterm infants. Methods This retrospective study was conducted between January 2017 and December 2021. Premature infants born at 32 weeks’ gestational age in whom extubation had failed at least once were assigned to the EF group. Successfully extubated patients with a similar gestational age and birth weight as those in the EF group were assigned to the ES group. EF was defined as the need for re-intubation within 120 h of extubation. Various variables were compared between groups. Results The EF rate in this study was 18.6% (24/129), and approximately 80% of patients with EF required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12 [63.2%] vs. 22 [91.7%], p = 0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks (1.72 vs. 2.5, p = 0.026; 1.73 vs. 2.92, p = 0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p = 0.020). There was a higher severity of bronchopulmonary dysplasia BPD (3 [15.8%] vs. 14 [58.3%], p = 0.018), longer duration of oxygen supply (66.5 vs. 92.9, p = 0.042), and higher corrected age at discharge (39.6 vs. 42.5, p = 0.043) in the EF group. The cutoff value, sensitivity, and specificity of the respiratory severity score (RSS) at 1 week were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks were 2.22, 0.67, and 0.47, respectively. Conclusions EF caused adverse short-term outcomes such as a higher BPD severity and longer hospital stay. Therefore, extubation in very early preterm infants should be carefully evaluated. Using inotropes, feeding, and RSS at 1 week of age can help predict extubation success.

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Section: Discussionmentioning

confidence: 99%

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

et al. 2023

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“…The rate of EF in preterm infants is relatively high, and preterm infants with EF are more likely to have long-term complications, such as ventilator-associated pneumonia and BPD. [2][3][4][5] Previous studies reported that the use of inotropes in preterm infants at an early age of birth is associated with a higher risk of death, IVH, and BPD [11][12][13]. In particular, it has been reported that hypotension treatment in early life can affect changes in cerebral blood ow, causing IVH or hydrocephalus and long-term neurodevelopmental delays.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

Park

Bae

Jeong

et al. 2022

Preprint

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Background Early extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short-term and long-term outcomes. Therefore, the present study aimed to identify the differences in risk factors and clinical outcomes between ES and EF in very early preterm infants. Methods This retrospective study was conducted between January 2017 and December 2021. We enrolled premature infants born under the gestational age of 32 weeks who failed extubation even once in the EF group, and patients with similar gestational age and birth weight to the EF group and successful extubation at once were assigned to the ES group. EF was defined as the need for reintubation within 120 hours after extubation. Various variables were analyzed between the two groups. Results EF rate in this study was 18.6% (24/129), and approximately 80% of EF patients required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12(63.2%) vs. 22(91.7%), p=0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks of age (1.72 vs. 2.5, p=0.026, 1.73 vs. 2.92, p=0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p=0.020). There was a higher severity of BPD (3(15.8%) vs. 14(58.3%), p=0.018), a longer duration of oxygen supply (66.5 vs. 92.9, p=0.042), and higher corrected age at discharge (39.6 vs. 42.5, p=0.043) in the EF group. The cutoff value, sensitivity, and specificity of the RSS at 1 week of age were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks of age were 2.22, 0.67, and 0.47, respectively Conclusions EF can cause adverse short-term outcomes, such as a higher severity of BPD and a longer duration of hospital days. Therefore, extubation in very early preterm infants should be attempted carefully. The use of inotropes and proceeding feeding and RSS at 1 week of age can be helpful to predict successful extubation.

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“…This study included all infants with birth weight (BW) lower than 1500 g admitted to the study sites within 7 days of birth from May 1, 2015, to April 30, 2018. Their clinical data were abstracted from the database of “Reduction of Infection in Neonatal Intensive Care Units using the Evidence-based Practice for Improving Quality (REIN-EPIQ)”, a multicenter NICU research database in China (Luo et al, 2021). Participants who did not receive enteral feeding or who received mixed feeding during hospitalization were excluded.…”

Section: Methodsmentioning

confidence: 99%

The Association of Human Milk Feeding With Short-Term Health Outcomes Among Chinese Very/Extremely Low Birth Weight Infants

Peng

Han

et al. 2022

J Hum Lact

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Background: There is limited evidence about the influence of human milk feeding on short-term outcomes in a large preterm infant population. Research Aims: To explore the influences of human milk feeding on the primary outcome of necrotizing enterocolitis and secondarily sepsis, bronchial pulmonary dysplasia, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding at discharge in very/extremely low-birth-weight infants. Methods: This study was a retrospective, longitudinal, observational two-group comparison cohort study. A total of 4470 very/extremely low-birth-weight infants from 25 neonatal intensive care units in China, between April 2015 and May 2018, were enrolled in this study. Exclusive human milk-fed and formula-fed participants were matched using propensity scores. After matching, human milk-fed participants ( n = 1379) and formula-fed participants ( n = 1378) were included in the analyses. The likelihood of necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding were compared between the two groups. Results: Exclusive human milk feeding was associated with lower odds of necrotizing enterocolitis (2.90% vs. 8.42%, OR 0.33, 95% CI [0.22, 0.47]), bronchopulmonary dysplasia (15.74% vs. 20.26%, OR 0.69, 95% CI [0.56, 0.86]), severe retinopathy of prematurity (1.45% vs. 2.39%, OR 0.50, 95% CI [0.27, 0.93]), and death (6.02% vs. 10.38%, OR 0.44, 95% CI [0.32, 0.61]) compared with formula feeding. No significant differences in the time to achieve full enteral feeding or the odds of sepsis were found between the two groups. Conclusion: Exclusive human milk feeding is associated with a reduction in necrotizing enterocolitis, bronchopulmonary dysplasia, severe retinopathy of prematurity, and mortality among very/extremely low-birth-weight infants. Trial registration: Clinicaltrials.gov on November 9, 2015 (NCT02600195).

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Cardiovascular Pharmacological Support Among Preterm Infants in Chinese Referral Center Neonatal Intensive Care Units

Cited by 3 publications

References 43 publications

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

Risk factors and clinical outcomes of extubation failure in very early preterm infants: a single-center cohort study

The Association of Human Milk Feeding With Short-Term Health Outcomes Among Chinese Very/Extremely Low Birth Weight Infants

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