Effect of a Novel Oxygen Saturation Targeting Strategy on Mortality, Retinopathy of Prematurity, and Bronchopulmonary Dysplasia in Neonates Born Extremely Preterm

Srivatsa, Bharath; Malcolm, Karlous; Clark, Reese H.; Kupke, Kenneth G.

doi:10.1016/j.jpeds.2021.03.007

Cited by 13 publications

(9 citation statements)

References 18 publications

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“…There was no difference, however, in the length of stay in the NICU, mortality, or morbidity during the study periods [64]. On the contrary, in another retrospective cohort study, improvement in rates of mortality, any ROP, ROP requiring treatment, and BPD was reported after implementation of a specific novel oxygen management strategy [65].…”

Section: Oxygen Therapy: Saturation Targets and Automated Controlmentioning

confidence: 82%

The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

et al. 2021

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Defining improvements in healthcare can be challenging due to the need to assess multiple outcomes and measures. In neonates, although progress in respiratory support has been a key factor in improving survival, the same degree of improvement has not been documented in certain outcomes, such as bronchopulmonary dysplasia. By exploring the evolution of neonatal respiratory care over the last 60 years, this review highlights not only the scientific advances that occurred with the application of invasive mechanical ventilation but also the weakness of the existing knowledge. The contributing role of non-invasive ventilation and less-invasive surfactant administration methods as well as of certain pharmacological therapies is also discussed. Moreover, we analyze the cost–benefit of neonatal care-respiratory support and present future challenges and perspectives.

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Section: Oxygen Therapy: Saturation Targets and Automated Controlmentioning

confidence: 82%

The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

et al. 2021

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“…An in vivo study indicated that hyperoxia treatment is a useful therapeutic strategy in targeting pathological neovascularization in ischemic retinopathy, and does not have the inflammatory effect related to anti-VEGF therapies ( 37 ). A novel oxygen management strategy has been found to decrease the rate of ROP ( 38 ). Future studies may be needed to further investigate the roles and mechanisms of circRNAs in oxygen transport in ROP.…”

Section: Discussionmentioning

confidence: 99%

Potential biomarkers for retinopathy of prematurity identified by circular RNA profiling in peripheral blood mononuclear cells

Zhou

Huang

et al. 2022

Front. Immunol.

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PurposeThis study aims to reveal the altered expression profiles of circular RNAs (circRNAs) in the peripheral blood mononuclear cells (PBMCs) of patients with retinopathy of prematurity (ROP), and to identify potential biomarkers for ROP diagnosis.MethodsDifferentially expressed circRNAs in PBMCs of five infants with ROP and five controls were identified using microarray analysis. Twelve altered circRNAs were validated using reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR). Bioinformatic analyses were conducted to predict the circRNA/miRNA interactions, competing endogenous RNA (ceRNA) network, related biological functions, and signaling pathways. Four selected circRNAs in PBMCs were verified using RT-qPCR in another cohort, including 24 infants with ROP and 23 premature controls, and receiver operating characteristic (ROC) curves were used to estimate their potential as diagnostic biomarkers of ROP.ResultsA total of 54 and 143 circRNAs were significantly up- and down-regulated, respectively, in the PBMCs of patients with ROP compared with controls. Twelve of the significantly altered circRNAs were preliminarily validated by RT-qPCR, which confirmed the reliability of the microarray analysis. The circRNA/miRNA interactions and ceRNA network were displayed according to the altered circRNAs. Three circRNAs (hsa_circRNA_061346, hsa_circRNA_092369, and hsa_circRNA_103554) were identified as potential diagnostic biomarkers for ROP with certain clinical values.ConclusionsCircRNAs were significantly altered in PBMCs of treatment-requiring ROP patients. CircRNAs may be used as potential biomarkers and possible therapeutic targets for ROP.

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“…Other factors that may have contributed to our favorable outcomes include lower rates of sepsis and surgical NEC (Table 1). We have previously described our quality improvement efforts toward improving oxygen saturation (SpO 2 ) targeting using simultaneous SpO 2 and fraction of inspired oxygen (FiO 2 ) recording 8 . This is now a standard practice in our unit.…”

Section: Discussionmentioning

confidence: 99%

Assessment of validity and utility of a bronchopulmonary dysplasia outcome estimator

Srivatsa

Srivatsa²,

Clark

2022

Pediatric Pulmonology

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Objective To assess the validity and utility of the bronchopulmonary dysplasia (BPD) outcome estimator developed by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Methods This retrospective study correlated the BPD and mortality outcomes of 23–28‐week prematurely born infants with those predicted by the 2022 NICHD BPD outcome estimator. In addition, evidence‐based recommended postnatal steroid administration using risk predictions by the BPD estimator was compared with actual postnatal steroid use. Results Among the 223 infants enrolled in the study, 139 did not develop BPD, 64 babies developed BPD, and 20 babies died. BPD estimator predicted outcomes correctly in 74% of cases who did not develop BPD, 48% of cases with Grade 1 BPD, and 35% of deaths. Only 6% of cases with Grade 2 BPD and none of the babies with Grade 3 BPD were identified correctly. The predicted and actual steroid use for BPD prevention/treatment were 37.2% and 29.6%, respectively (p = 0.18). The BPD estimator had a sensitivity of 72.7%, specificity of 77.7%, positive predictive value of 57.8%, and negative predictive value of 87.1% to predict actual postnatal steroid use. Conclusions In this cohort, the 2022 NICHD BPD estimator underestimated probabilities for babies who did not develop BPD, may overestimate probabilities for babies who develop BPD and had low sensitivity to predict mortality. In addition, the application of the BPD estimator may result in an overestimation of postnatal steroid use.

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Effect of a Novel Oxygen Saturation Targeting Strategy on Mortality, Retinopathy of Prematurity, and Bronchopulmonary Dysplasia in Neonates Born Extremely Preterm

Cited by 13 publications

References 18 publications

The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

Potential biomarkers for retinopathy of prematurity identified by circular RNA profiling in peripheral blood mononuclear cells

Assessment of validity and utility of a bronchopulmonary dysplasia outcome estimator

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