3 results on '"Torchin, H."'
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2. Postnatal Corticosteroids Policy for Very Preterm Infants and Bronchopulmonary Dysplasia
- Author
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Nuytten, A, Behal, H, Duhamel, A, Jarreau, PH, Torchin, H, Milligan, D, Maier, RF, Zemlin, M, Zeitlin, J, Truffert, P, EPICE Research Group, and Instituto de Saúde Pública da Universidade do Porto
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Pediatrics ,medicine.medical_specialty ,EPICE cohort ,Gestational Age ,03 medical and health sciences ,0302 clinical medicine ,Case mix index ,Adrenal Cortex Hormones ,030225 pediatrics ,Intensive care ,mental disorders ,Medicine ,Humans ,Infant, Very Low Birth Weight ,030212 general & internal medicine ,Adverse effect ,Bronchopulmonary Dysplasia ,business.industry ,Infant, Newborn ,Gestational age ,Infant ,Odds ratio ,medicine.disease ,Bronchopulmonary dysplasia ,Confidence interval ,Policy ,Very preterm infants ,Pediatrics, Perinatology and Child Health ,Cohort ,business ,Infant, Premature ,Developmental Biology ,Postnatal corticosteroids - Abstract
Introduction: Postnatal corticosteroids (PNC) are effective for reducing bronchopulmonary dysplasia (BPD) in very preterm neonates but are associated with adverse effects including an increased risk of cerebral palsy. PNC use in Europe is heterogeneous across regions. This study aimed to assess whether European neonatal intensive care units (NICUs) with a low use of PNC or an explicit policy to reduce PNC use had higher risks of mortality or BPD. Methods: We included 3,126 infants in 105 NICUs born between 24 + 0 and 29 + 6 weeks’ gestational age in 19 regions in 11 countries in the EPICE cohort. First, we identified clusters of NICUs using hierarchical clustering based on PNC use and BPD prevalence and compared case mix and mortality between the clusters. Second, a multilevel analysis was performed to evaluate the association between a restrictive PNC policy and BPD occurrence. Results: There were 3 clusters of NICUs: 52 with low PNC use and a low BPD rate, 37 with low PNC use and a high BPD rate, and 16 with high PNC use and a medium BPD rate. Neonatal mortality did not differ between clusters (p = 0.88). A unit policy of restricted PNC use was not associated with a higher risk of BPD (odds ratio 0.68; 95% confidence interval: 0.45–1.03) after adjustment. Conclusion: Up to 49% of NICUs had low PNC use and low BPD rates, without a difference in mortality. Infants hospitalized in NICUs with a stated policy of low PNC use did not have an increased risk of BPD. The research leading to these results received funding from the European Union’s Seventh Framework Programme ([FP7/2007–2013]) under grant agreement No. 259882. We acknowledge additional funding from the following regions: France (French Institute of Public Health Research/Institute of Public Health and its partners the French Health Ministry, the National Institute of Health and Medical Research, the NationalInstitute of Cancer, and the National Solidarity Fund for Autonomy; grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future; and the PremUp Foundation); Poland (2012–2015 allocation of funds for international projects from the Polish Ministry of Science and Higher Education); Sweden (Stockholm County Council ALF-project and Clinical Research Appointment and the Department of Neonatal Medicine, Karolinska University Hospital); and the UK (the Neonatal Survey from Neonatal Networks for East Midlands and Yorkshire and Humber regions).
- Published
- 2020
3. Early extubation is not associated with severe intraventricular hemorrhage in preterm infants born before 29 weeks of gestation. Results of an EPIPAGE-2 cohort study
- Author
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Chevallier, M. (Marie), Ancel, P-Y. (Pierre-Yves), Torchin, H. (Heloise), Marchand-Martin, L. (Laetitia), Lorthe, E. (Elsa), Truffert, P. (Patrick), Jarreau, P-H. (Pierre-Henri), Roze, J-C. (Jean-Christophe), Pierrat, V. (Véronique), Marret, S. (Stéphane), Baud, O. (Olivier), Benhammou, V. (Valérie), Ego, A. (Anne), Debillon, T. (Thierry), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Service de Médecine Néonatale, Université de Nantes (UN), Team 4 'NeoVasc' - INSERM U1245, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de soins intensifs néonatals [AP-HP Hôpital Robert Debré], AP-HP Hôpital universitaire Robert-Debré [Paris], Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Registre des Handicaps de l'Enfant et Observatoire Périnatal Isère, RHEOP, Gonzalez, Bruno, Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology Research Unit [Porto, Portugal] (EPIUnit), Instituto de Saúde Pública [Porto, Portugal], Universidade do Porto = University of Porto-Universidade do Porto = University of Porto, Universidade do Porto = University of Porto, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Rouen, Normandie Université (NU), Geneva University Hospital (HUG), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Universidade do Porto-Universidade do Porto, Universidade do Porto, CHU Lille, Université de Lille, METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694, Techniques pour l'Evaluation et la Modélisation des Actions de la Santé [TIMC-IMAG-ThEMAS], Hôpital Cochin [AP-HP], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique [CRESS - U1153], Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS], Université Paris Descartes - Paris 5 [UPD5], Centre hospitalier universitaire de Nantes [CHU Nantes], and Hôpitaux Universitaires de Genève [HUG]
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Critical Care and Emergency Medicine ,[SDV]Life Sciences [q-bio] ,Surfactants ,Maternal Health ,Pathology and Laboratory Medicine ,Vascular Medicine ,Pediatrics ,Neonatal Care ,Cohort Studies ,Labor and Delivery ,Pregnancy ,Risk Factors ,Medicine and Health Sciences ,Materials ,ComputingMilieux_MISCELLANEOUS ,ddc:618 ,Infant, Premature/physiology ,Obstetrics and Gynecology ,[SDV] Life Sciences [q-bio] ,Research Design ,Physical Sciences ,Premature Birth ,Medicine ,Female ,Airway Extubation/adverse effects ,Infant, Premature ,Premature Birth/pathology ,Research Article ,Resuscitation ,Science ,Materials Science ,Hemorrhage ,Surgical and Invasive Medical Procedures ,macromolecular substances ,Research and Analysis Methods ,Signs and Symptoms ,Diagnostic Medicine ,Humans ,Propensity Score ,Cerebral Hemorrhage ,Biology and Life Sciences ,Neonates ,Cerebral Hemorrhage/etiology ,Health Care ,Airway Extubation ,Birth ,Women's Health ,Neonatology ,Intubation ,Developmental Biology - Abstract
ObjectiveTo determine whether there is an association between severe intraventricular hemorrhage and early extubation in preterm infants born before 29 weeks of gestational age and intubated at birth.MethodsThis study included 1587 preterm infants from a nationwide French population cohort (EPIPAGE-2). Secondary data on intubated preterm infants were analyzed. After gestational age and propensity score matching (1:1) we built two comparable groups: an early extubation group and a delayed extubation group. Each neonate in one group was paired with a neonate in the other group having the same propensity score and gestational age. Early extubation was defined as extubation within 48 hours of life. Severe intraventricular hemorrhages were defined as grade III or IV hemorrhages according to the Papile classification.ResultsAfter matching, there were 398 neonates in each group. Using a generalized estimating equation model, we found that intraventricular hemorrhage was not associated with early extubation (adjusted OR 0.9, 95%CI 0.6-1.4). This result was supported by sensitivity analyses.ConclusionThe practice of early extubation was not associated with an increased proportion of intraventricular hemorrhages. To complete these results, the long-term neurologic outcomes of these infants need to be assessed.
- Published
- 2019
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