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Growth Outcomes of Preterm Infants Exposed to Different Oxygen Saturation Target Ranges from Birth - 25/08/16

Doi : 10.1016/j.jpeds.2016.05.070 
Cristina T. Navarrete, MD 1, , Lisa A. Wrage, MPH 2, Waldemar A. Carlo, MD 3, Michele C. Walsh, MD, MS 4, Wade Rich, RRT 5, Marie G. Gantz, PhD 2, Abhik Das, PhD 6, Kurt Schibler, MD 7, Nancy S. Newman, RN 5, Anthony J. Piazza, MD 8, Brenda B. Poindexter, MD, MS 9, Seetha Shankaran, MD 10, Pablo J. Sánchez, MD 11, Brenda H. Morris, MD 12, Ivan D. Frantz, MD 13, Krisa P. Van Meurs, MD 14, C. Michael Cotten, MD, MHS 15, Richard A. Ehrenkranz, MD 16, Edward F. Bell, MD 17, Kristi L. Watterberg, MD 18, Rosemary D. Higgins, MD 19, Shahnaz Duara, MD 1
on behalf of the

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

  List of additional members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network is available at www.jpeds.com (Appendix).
Abhik Das, Marie Gantz, Alan H. Jobe, MD, PhD, Michael S. Caplan, MD, Avroy A. Fanaroff, MD, Deanne E. Wilson-Costello, MD, Bonnie S. Siner, RN, Arlene Zadell, RN, Julie DiFiore, BS, Monika Bhola, MD, Harriet G. Friedman, MA, Gulgun Yalcinkaya, MD, Edward F. Donovan, MD, Vivek Narendran, MD, MRCP, Kimberly Yolton, PhD, Kate Bridges, MD, Barbara Alexander, RN, Cathy Grisby, BSN, CCRC, Marcia Worley Mersmann, RN, CCRC, Holly L. Mincey, RN, BSN, Jody Hessling, RN, Teresa L. Gratton, PA, Ronald N. Goldberg, MD, Ricki F. Goldstein, MD, Patricia Ashley, MD, Kathy J. Auten, MSHS, Kimberley A. Fisher, PhD, FNP-BC, IBCLC, Katherine A. Foy, RN, Sharon F. Freedman, MD, Kathryn E. Gustafson, PhD, Melody B. Lohmeyer, RN, MSN, William F. Malcolm, MD, David K. Wallace, MD, MPH, Barbara J. Stoll, MD, Ira Adams-Chapman, MD, Susie Buchter, MD, David P. Carlton, MD, Sheena Carter, PhD, Sobha Fritz, PhD, Ellen C. Hale, RN, BS, CCRC, Amy K. Hutchinson, MD, Maureen Mulligan LaRossa, RN, Gloria V. Smikle, PNP, MSN, Stephanie Wilson Archer, MA, Anna M. Dusick, MD, FAAP, James A. Lemons, MD, Gary J. Myers, MD, Leslie D. Wilson, BSN, CCRC, Faithe Hamer, BS, Ann B. Cook, MS, Dianne E. Herron, RN, Carolyn Lytle, MD, MPH, Heike M. Minnich, PsyD, HSPP, Mary Anne Berberich, PhD, Carol J. Blaisdell, MD, Dorothy B. Gail, PhD, James P. Kiley, PhD, W. Kenneth Poole, PhD, Jamie E. Newman, PhD, MPH, Betty K. Hastings, Jeanette O'Donnell Auman, BS, Carolyn Petrie Huitema, MS, James W. Pickett, BS, Dennis Wallace, PhD, Kristin M. Zaterka-Baxter, RN, BSN, David K. Stevenson, MD, Susan R. Hintz, MD, MS Epi, M. Bethany Ball, BS, CCRC, Barbara Bentley, PsychD, MSEd, Elizabeth F. Bruno, PhD, Alexis S. Davis, MD, MS, Maria Elena DeAnda, PhD, Anne M. DeBattista, RN, PNP, Lynne C. Huffman, MD, Jean G. Kohn, MD, MPH, Melinda S. Proud, RCP, Renee P. Pyle, PhD, Nicholas H. St. John, PhD, Hali E. Weiss, MD, John M. Fiascone, MD, Elisabeth C. McGowan, MD, Anne Furey, MPH, Brenda L. MacKinnon, RNC, Ellen Nylen, RN, BSN, Ana Brussa, MS, OTR/L, Cecelia Sibley, PT, MHA, Namasivayam Ambalavanan, MD, Myriam Peralta-Carcelen, MD, MPH, Monica V. Collins, RN, BSN, MaEd, Shirley S. Cosby, RN, BSN, Vivien A. Phillips, RN, BSN, Kirstin J. Bailey, PhD, Fred J. Biasini, PhD, Maria Hopkins, PhD, Kristen C. Johnston, MSN, CRNP, Sara Krzywanski, MS, Kathleen G. Nelson, MD, Cryshelle S. Patterson, PhD, Richard V. Rector, PhD, Leslie Rodriguez, PhD, Amanda Soong, MD, Sally Whitley, MA, OTR-L, FAOTA, Sheree York, PT, DPT, MS, PCS, John A. Widness, MD, Michael J. Acarregui, MD, MBA, Jonathan M. Klein, MD, Tarah T. Colaizy, MD, MPH, Karen J. Johnson, RN, BSN, Diane L. Eastman, RN, CPNP, MA, Charles R. Bauer, MD, Ruth Everett-Thomas, RN, MSN, Maria Calejo, MEd, Alexis N. Diaz, BA, Silvia M. Frade Eguaras, BA, Andrea Garcia, MA, Kasey Hamlin-Smith, PhD, Michelle Harwood Berkowits, PhD, Sylvia Hiriart-Fajardo, MD, Helina Pierre, BA, Arielle Rigaud, MD, Alexandra Stroerger, BA, Robin K. Ohls, MD, Janell Fuller, MD, Julie Rohr, MSN, RNC, CNS, Conra Backstrom Lacy, RN, Jean Lowe, PhD, Rebecca Montman, BSN, Luc Brion, MD, Charles R. Rosenfeld, MD, Walid A. Salhab, MD, Roy J. Heyne, MD, Sally S. Adams, MS, RN, CPNP, James Allen, RRT, Lijun Chen, RN, PhD, Laura Grau, RN, Alicia Guzman, Gaynelle Hensley, RN, Elizabeth T. Heyne, PsyD, PA-C, Jackie Hickman, RN, Melissa H. Lepps, RN, Linda A. Madden, RN, CPNP, Nancy A. Miller, RN, Janet S. Morgan, RN, Araceli Solis, RRT, Lizette E. Torres, RN, Catherine Twell Boatman, MS, CIMI, Diana M Vasil, RNC-NIC, Kathleen A. Kennedy, MD, MPH, Jon E. Tyson, MD, MPH, Esther G. Akpa, RN, BSN, Nora I. Alaniz, BS, Susan Dieterich, PhD, Patricia W. Evans, MD, Charles Green, PhD, Beverly Foley Harris, RN, BSN, Margarita Jiminez, MD, MPH, Anna E. Lis, RN, BSN, Karen Martin, RN, Sarah Martin, RN, BSN, Georgia E. McDavid, RN, Brenda H. Morris, MD, M. Layne Poundstone, RN, BSN, Stacey Reddoch, BA, Saba Siddiki, MD, Maegan C. Simmons, RN, Patti L. Pierce Tate, RCP, Sharon L. Wright, MT (ASCP), Beena G. Sood, MD, MS, Athina Pappas, MD, Rebecca Bara, RN, BSN, Elizabeth Billian, RN, MBA, Laura A. Goldston, MA, Mary Johnson, RN, BSN, Vineet Bhandari, MD, DM, Harris C. Jacobs, MD, Pat Cervone, RN, Patricia Gettner, RN, Monica Konstantino, RN, BSN, JoAnn Poulsen, RN, Janet Taft, RN, BSN, Christine G. Butler, MD, Nancy Close, PhD, Walter Gilliam, PhD, Sheila Greisman, RN, Elaine Romano, MSN, Joanne Williams, RN

1 University of Miami Miller School of Medicine, Miami, FL 
2 Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC 
3 Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL 
4 Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH 
5 Division of Neonatology, University of California San Diego, San Diego, CA 
6 Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD 
7 Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH 
8 Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, GA 
9 Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 
10 Department of Pediatrics, Wayne State University, Detroit, MI 
11 Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 
12 Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX 
13 Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, MA 
14 Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA 
15 Department of Pediatrics, Duke University, Durham, NC 
16 Department of Pediatrics, Yale University School of Medicine, New Haven, CT 
17 Department of Pediatrics, University of Iowa, Iowa City, IA 
18 University of New Mexico Health Sciences Center, Albuquerque, NM 
19 Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 

Reprint requests: Cristina T. Navarrete, MD, P.O. Box 016960 (R-131), Miami, FL 33136.P.O. Box 016960 (R-131)MiamiFL33136

Abstract

Objective

To test whether infants randomized to a lower oxygen saturation (peripheral capillary oxygen saturation [SpO2]) target range while on supplemental oxygen from birth will have better growth velocity from birth to 36 weeks postmenstrual age (PMA) and less growth failure at 36 weeks PMA and 18-22 months corrected age.

Study design

We evaluated a subgroup of 810 preterm infants from the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, randomized at birth to lower (85%-89%, n = 402, PMA 26 ± 1 weeks, birth weight 839 ± 186 g) or higher (91%-95%, n = 408, PMA 26 ± 1 weeks, birth weight 840 ± 191 g) SpO2 target ranges. Anthropometric measures were obtained at birth, postnatal days 7, 14, 21, and 28; then at 32 and 36 weeks PMA; and 18-22 months corrected age. Growth velocities were estimated with the exponential method and analyzed with linear mixed models. Poor growth outcome, defined as weight <10th percentile at 36 weeks PMA and 18-22 months corrected age, was compared across the 2 treatment groups by the use of robust Poisson regression.

Results

Growth outcomes including growth at 36 weeks PMA and 18-22 months corrected age, as well as growth velocity were similar in the lower and higher SpO2 target groups.

Conclusion

Targeting different oxygen saturation ranges between 85% and 95% from birth did not impact growth velocity or reduce growth failure in preterm infants.

Le texte complet de cet article est disponible en PDF.

Keywords : ELBW growth, oxygen saturation target

Abbreviations : BPD, FiO2, PMA, ROP, RR, SpO2, SUPPORT


Plan


 The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute provided grant support for the Neonatal Research Network's SUPPORT Trial. Additional funding information is available at www.jpeds.com (Appendix). Participating sites collected data and transmitted it to RTI International, the data coordinating center for the network, which stored, managed, and analyzed the data for this study. The authors declare no conflicts of interest.


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Vol 176

P. 62 - septembre 2016 Retour au numéro
Article précédent Article précédent
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