Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

Abstract

Objectives: To identify the variables that predict death/physiologic bronchopulmonary dysplasia (BPD) in preterm infants with severe respiratory failure.Study Design: The study was a secondary analysis of data from the NICHD Neonatal Research Network trial of inhaled nitric oxide (iNO) in preterm infants. Stepwise logistic regression models and Classification and Regression Tree (CART) models were developed for the outcome of death or physiologic BPD (O 2 at 36 weeks post-menstrual age).Result: Death and/or BPD was associated with lower birth weight, higher oxygen requirement, male gender, additional surfactant doses, higher oxygenation index and outborn status, but not the magnitude of response in PaO 2 to iNO. The positive predictive value of the CART model was 82% at 95% sensitivity. Conclusions:The major factors associated with death/BPD were an increased severity of respiratory failure, lower birth weight, male gender and outborn status, but not the magnitude of initial response to iNO.

Outcomes of Children With Severe Bronchopulmonary Dysplasia Who Were Ventilator Dependent at Home

“…We also showed that lower weight was associated with earlier death, a finding supported by earlier studies. [29][30][31] Although several articles 32,33 report a higher readmission rate in the first year of life for patients with BPD in general, we could not report the readmission rate for the first year of life because the length of the initial hospital stay was very long. This length of stay is probably secondary to the need for extensive caregiver training in ventilator and tracheostomy care, as previously described.…”

“…Within the group of patients who were alive at the end of this study, 69 (83.1%) patients were weaned off the PPV and 60 (72.2%) patients were decannulated. Sixty-seven (97.1%) of 69 patients liberated from PPV were ARTICLE weaned within the first 5 years of life, with a median age at liberation of 24 months (IQR, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Similarly, 58 (96.7%) of the 60 decannulated patients completed this process within the first 6 years of life, with a median age at decannulation of 37.5 months (IQR, 31.5-45).…”

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

“…Incidência e principais fatores associados à falha de extubação em recém-nascidos com peso de nascimento < 1.250 gramas do desenvolvimento neuropsicomotor e óbito [1][2][3][4] . Esforços para limitar a duração da ventilação invasiva têm como objetivo principal reduzir essas complicações.…”

Bronchopulmonary Dysplasia: The Role of Oxidative Stress

“…Factors linked to BPD include: 1) low gestational age at birth (Kraybill et al, 1989;Darlow & Horwood, 1992;Antonucci et al, 2004;Ambalavanan & Novak, 2003), 2) low birth weight (Darlow & Horwood, 1992;Hakulinenet al, 1988;Avery et al, 1987;Ambalavanan et al, 2008), 3) growth restriction (small for gestational age) (Durrmeyer X et al, 2011;Lal Mk et al, 2003;Zeitlin J et al, 2010), 4) male sex (Kraybill et al, 1989;Darlow & Horwood, 1992;Ambalavanan & Novak, 2003;Avery et al, 1987), and 5) white race (Avery et al, 1987;Palta et al, 1991). In a recent cohort, BPD affected 85% of infants born at 22 weeks' gestation vs. 23% of those born at 28 weeks' (Stoll et al, 2010).…”