Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort - 14/12/17
Doi : 10.1016/j.jpeds.2017.01.057
Juliann M. Di Fiore, BSEE 1, * 
, Richard J. Martin, MD 1, Hong Li, MS 2, Nathan Morris, PhD 2, Waldemar A. Carlo, MD 3, Neil Finer, MD 4, Michele Walsh, MD 1
on behalf of the
, Richard J. Martin, MD 1, Hong Li, MS 2, Nathan Morris, PhD 2, Waldemar A. Carlo, MD 3, Neil Finer, MD 4, Michele Walsh, MD 1on behalf of the
SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network*
Alan H. Jobe, MD, PhD 1, Michael S. Caplan, MD 2, Richard A. Polin, MD 3, Abbot R. Laptook, MD 4, William Oh, MD 4, Angelita M. Hensman, MS, RNC-NIC, BSN 4, Dan Gingras, RRT 4, Susan Barnett, RRT 4, Sarah Lillie, RRT 4, Kim Francis, RN 4, Dawn Andrews, RN 4, Kristen Angela, RN 4, Avroy A. Fanaroff, MD 5, Nancy S. Newman, RN 5, Bonnie S. Siner, RN 5, Arlene Zadell, RN 5, Kurt Schibler, MD 6, Edward F. Donovan, MD 6, Kate Bridges, MD 6, Barbara Alexander, RN 6, Cathy Grisby, BSN, CCRC 6, Marcia Worley Mersmann, RN, CCRC 6, Holly L. Mincey, RN, BSN 6, Jody Hessling, RN 6, Ronald N. Goldberg, MD 7, C. Michael Cotten, MD, MHS 7, David K. Wallace, MD MPH 7, Sharon F. Freedman, MD 7, Kathy J. Auten, MSHS 7, Kimberly A. Fisher, PhD, FNP-BC, IBCLC 7, Katherine A. Foy, RN 7, Barbara J. Stoll, MD 8, Anthony J. Piazza, MD 8, Susie Buchter, MD 8, David P. Carlton, MD 8, Amy K. Hutchinson, MD 8, Ellen C. Hale, RN, BS, CCRC 8, Rosemary D. Higgins, MD 9, Stephanie Wilson Archer, MA 9, Brenda B. Poindexter, MD, MS 10, James A. Lemons, MD 10, Faithe Hamer, BS 10, Dianne E. Herron, RN 10, Lucy C. Miller, RN, BSN, CCRC 10, Leslie D. Wilson, BSN, CCRC 10, Mary Anne Berberich, PhD 11, Carol J. Blaisdell, MD 11, Dorothy B. Gail, PhD 11, James P. Kiley, PhD 11, Marie G. Gantz, PhD 12, Abhik Das, PhD 12, Margaret M. Crawford, BS, CCRP 12, Betty K. Hastings 12, Amanda R. Irene, BS 12, Jeanette O'Donnell Auman, BS 12, Carolyn Petrie Huitema, MS, CCRP 12, James W. Pickett, BS 12, Dennis Wallace, PhD 12, Kristin M. Zaterka-Baxter, RN, BSN, CCRP 12, Krisa P. Van Meurs, MD 13, David K. Stevenson, MD 13, M. Bethany Ball, BS, CCRC 13, Melinda S. Proud, RCP 13, Ivan D. Frantz, MD 14, John M. Fiascone, MD 14, Anne Furey, MPH 14, Brenda L. MacKinnon, RNC 14, Ellen Nylen, RN, BSN 14, Namasivayam Ambalavanan, MD 15, Monica V. Collins, RN, BSN, MaEd 15, Shirley S. Cosby, RN, BSN 15, Vivien A. Phillips, RN, BSN 15, Maynard R. Rasmussen, MD 16, Paul R. Wozniak, MD 16, Wade Rich, RRT 16, Kathy Arnell, RNC 16, Renee Bridge, RN 16, Clarence Demetrio, RN 16, Edward F. Bell, MD 17, John A. Widness, MD 17, Jonathan M. Klein, MD 17, Karen J. Johnson, RN, BSN 17, Shahnaz Duara, MD 18, Ruth Everett-Thomas, RN, MSN 18, Kristi L. Watterberg, MD 19, Robin K. Ohls, MD 19, Julie Rohr, MSN, RNC, CNS 19, Conra Backstrom Lacy, RN 19, Dale L. Phelps, MD 20, Nirupama Laroia, MD 20, Gary David Markowitz, MD 20, Linda J. Reubens, RN, CCRC 20, Erica Burnell, RN 20, Pablo J. Sánchez, MD 21, Charles R. Rosenfeld, MD 21, Walid A. Salhab, MD 21, James Allen, RRT 21, Laura Grau, RN 21, Alicia Guzman 21, Gaynelle Hensley, RN 21, Melissa H. Lepps, RN 21, Melissa Martin, RN 21, Nancy A. Miller, RN 21, Araceli Solis, RRT 21, Diana M Vasil, RNC-NIC 21, Kerry Wilder, RN 21, Kathleen A. Kennedy, MD, MPH 22, Jon E. Tyson, MD, MPH 22, Brenda H. Morris, MD 22, Beverly Foley Harris, RN, BSN 22, Anna E. Lis, RN, BSN 22, Sarah Martin, RN, BSN 22, Georgia E. McDavid, RN 22, Patti L. Tate, RCP 22, Sharon L. Wright, MT, (ASCP) 22, Bradley A. Yoder, MD 23, Roger G. Faix, MD 23, Jill Burnett, RN 23, Jennifer J. Jensen, RN, BSN 23, Karen A. Osborne, RN, BSN, CCRC 23, Cynthia Spencer, RNC 23, Kimberlee Weaver-Lewis, RN, BSN 23, T. Michael O'Shea, MD, MPH 24, Nancy J. Peters, RN, CCRP 24, Seetha Shankaran, MD 25, Beena G. Sood, MD, MS 25, Rebecca Bara, RN, BSN 25, Elizabeth Billian, MBA 25, Mary Johnson, RN, BSN 25, Richard A. Ehrenkranz, MD 26, Vivek Narendran, MD, MRCP 26, Vineet Bhandari, MD, DM 26, Harris C. Jacobs, MD 26, Pat Cervone, RN 26, Patricia Gettner, RN 26, Monica Konstantino, RN, BSN 26, JoAnn Poulsen, RN 26, Janet Taft, RN, BSN 26
1 University of Cincinnati
2 University of Chicago, Pritzker School of Medicine
3 Division of Neonatology, College of Physicians and Surgeons, Columbia University
4 Alpert Medical School of Brown University, Women & Infants Hospital in Rhode Island
5 Case Western Reserve University, Rainbow Babies & Children's Hospital
6 Cincinnati Children's Hospital Medical Center, University of Cincinnati Hospital, Good Samaritan Hospital
7 Duke University School of Medicine, University Hospital, Alamance Regional Medical Center, Durham Regional Hospital
8 Emory University, Children's Healthcare of Atlanta, Grady Memorial Hospital, Emory Crawford Long Hospital
9 Eunice Kennedy Shriver National Institute of Child Health and Human Development
10 Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, Wishard Health Services
11 National Heart, Lung, and Blood Institute
12 RTI International
13 Stanford University, Lucile Packard Children's Hospital
14 Tufts Medical Center, Floating Hospital for Children
15 University of Alabama at Birmingham Health System, The Children's Hospital of Alabama
16 University of California—San Diego Medical Center, Sharp Mary Birch Hospital for Women & Newborns
17 University of Iowa
18 University of Miami, Holtz Children's Hospital
19 University of New Mexico Health Sciences Center
20 University of Rochester Medical Center, Golisano Children's Hospital
21 University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, Children's Medical Center
22 University of Texas Health Science Center at Houston, Medical School, Children's Memorial Hermann Hospital
23 University of Utah Medical Center, Intermountain Medical Center, LDS Hospital, Primary Children's Medical Center
24 Wake Forest University Baptist Medical Center, Brenner Children's Hospital, Forsyth Medical Center
25 Wayne State University, Hutzel Women's Hospital, Children's Hospital of Michigan
26 Yale University, Yale New Haven Children's Hospital, Bridgeport Hospital
1 Division of Neonatology, Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University, Cleveland, OH
2 Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH
3 Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
4 Department of Pediatrics, University of California, San Diego, CA
*Reprint requests: Division of Neonatology, Room 3100, Rainbow Babies & Children's Hospital, Department of Pediatrics, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.Division of NeonatologyRoom 3100Rainbow Babies & Children's HospitalDepartment of PediatricsCase Western Reserve University11100 Euclid AveClevelandOH44106
Abstract |
Objective |
To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial.
Study design |
Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5 minutes) were documented in 1054 infants of 240/7-276/7 weeks of gestation while receiving supplemental oxygen during the first 3 days of life.
Results |
Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA.
Conclusion |
Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival.
Trial registration |
ClinicalTrials.gov: NCT00233324.
Le texte complet de cet article est disponible en PDF.Keywords : hypoxia, small for gestational age, supplemental oxygen, oxygen saturation, intermittent hypoxemia
Abbreviations** : AGA, COT, HR, SGA, SUPPORT
Plan
| Supported by The National Institutes of Health (NIH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Heart, Lung, and Blood Institute (NHLBI), and the National Center for Research Resources, and the National Center for Advancing Translational Sciences (1RO3HD078528-01A1, U10 HD21364, U10 HD21373, U10 HD21385, U10 HD21397, U10 HD27851, U10 HD27853, U10 HD27856, U10 HD27880, U10 HD27871, U10 HD27904, U10 HD34216, U10 HD36790, U10 HD40461, U10 HD40492, U10 HD40498, U10 HD40521, U10 HD40689, U10 HD53089, U10 HD53109, U10 HD53119, and U10 HD53124, M01 RR30, M01 RR32, M01 RR39, M01 RR44, M01 RR54, M01 RR59, M01 RR64, M01 RR70, M01 RR80, MO1 RR125, M01 RR633, M01 RR750, M01 RR997, M01 RR6022, M01 RR7122, M01 RR8084, M01 RR16587, UL1 RR25008, UL1 RR24139, UL1 RR24979, and UL1 RR25744). Participating Neonatal Research Network (NRN) sites collected and transmitted data to RTI International, the data coordinating center (DCC) for the network, which stored, and managed the data for this study. The authors declare no conflicts of interest. |
© 2017
Elsevier Inc. Tous droits réservés.
Vol 186
P. 49 - juillet 2017 Retour au numéro
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