1. Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants
- Author
-
Carmen Garcia, Namasivayam Ambalavanan, Estelle E. Fischer, John D.E. Barks, Rosemary D. Higgins, Kristi L. Watterberg, Mary Christensen, Jeanette O'Donnell Auman, Abbot R. Laptook, Ronnie Guillet, David K. Stevenson, Lijun Chen, Dianne E. Herron, Karen Martin, Conra Backstrom Lacy, Eugenia K. Pallotto, Rachel Geller, Shirley S. Cosby, Teresa Chanlaw, C. Michael Cotten, Myra H. Wyckoff, Yvonne Loggins, Elisa Vieira, Seetha Shankaran, Patricia Luzader, Kristin M. Zaterka-Baxter, Stephanie Wilson Archer, Jenna Gabrio, Jennifer Fuller, Diane I. Bottcher, Haresh Kirpalani, Carl T. D'Angio, Joanne Finkle, Holly I.M. Wadkins, Luc P. Brion, Cindy Clark, Janice Bernhardt, Barbara J. Stoll, Brenda B. Poindexter, Howard W. Kilbride, Jennifer Jennings, Matthew M. Laughon, Suhas G. Kallapur, Meena Garg, Margaret M. Crawford, Satyan Lakshminrusimha, Pablo J. Sánchez, Jon E. Tyson, Uday Devaskar, Abhik Das, Tarah T. Colaizy, Angelita M. Hensman, Jacky R. Walker, Carol Hartenberger, Cathy Grisby, Barbara Alexander, Sarah Kandefer, Robin K. Ohls, Ronald N. Goldberg, Julie Gutentag, Shelley Handel, Kathleen A. Kennedy, Bonnie S. Siner, Sandy Sundquist Beauman, William E Truog, Sharon L. Wright, Athina Pappas, Girija Natarajan, Marliese Dion Nist, Marissa E. Jones, Jodi A. Ulloa, Kristin Kirker, Melinda S. Proud, Betty R. Vohr, Sara B. DeMauro, Nancy S. Newman, Dara M. Cucinotta, Waldemar A. Carlo, Krisa P. Van Meurs, Greg Muthig, Lizette E. Torres, Kimberley A. Fisher, Donia B. Campbell, Edward F. Bell, Lenora Jackson, Rosemary L. Jensen, Cheri Gauldin, Soraya Abbasi, Dan L. Ellsbury, Monica V. Collins, Greg Sokol, Stephanie Guilford, Ellen C. Hale, Ann Marie Scorsone, Barbara Schmidt, Kathy Johnson, Karen J. Johnson, Dennis Wallace, Julianne Hunn, M. Bethany Ball, Anne Holmes, Diane F. White, Richard A. Polin, Noah Cook, Tara Wolfe, Julie Arldt-McAlister, Sudarshan R. Jadcherla, Jane E. Brumbaugh, Shampa Saha, Ashley Williams, Diana M. Vasil, Monika Bajaj, Toni Mancini, Georgia E. McDavid, Elizabeth Rodgers, David P. Carlton, Sandra Wuertz, Rebecca Bara, Aasma S. Chaudhary, Sarah McGregor, Kurt Schibler, Anna Marie Hibbs, Michele C. Walsh, Nehal A. Parikh, Leif D. Nelin, Martin Keszler, Stephanie A. Wiggins, and Carl L. Bose
- Subjects
Male ,Resuscitation ,medicine.medical_treatment ,Article ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,030225 pediatrics ,Outcome Assessment, Health Care ,Intubation, Intratracheal ,Humans ,Rupture of membranes ,Medicine ,Prospective Studies ,Registries ,030212 general & internal medicine ,Cardiopulmonary resuscitation ,Continuous positive airway pressure ,Respiratory system ,Continuous Positive Airway Pressure ,business.industry ,Delivery Rooms ,Delivery room ,Infant, Newborn ,Oxygen Inhalation Therapy ,Gestational age ,Cardiopulmonary Resuscitation ,Anesthesia ,Infant, Small for Gestational Age ,Pediatrics, Perinatology and Child Health ,Female ,business ,Infant, Premature ,Cohort study - Abstract
Objectives To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. Study design This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use. The association of antepartum and intrapartum risk factors and discharge outcomes with the intensity of resuscitation was evaluated. Results Of 7014 included infants, 1684 (24.0%) received routine care and no additional resuscitation, 2279 (32.5%) received oxygen or continuous positive airway pressure, 1831 (26.1%) received bag and mask ventilation, 1034 (14.7%) underwent endotracheal intubation, and 186 (2.7%) received cardiopulmonary resuscitation. Among the antepartum and intrapartum factors, increasing GA, any exposure to antenatal steroids and prolonged rupture of membranes decreased the likelihood of receipt of all levels of resuscitation. Infants who were small for GA (SGA) had increased risk of delivery room resuscitation. Among the neonatal outcomes, respiratory support at 28 days, days to full oral feeds and length of stay were significantly associated with the intensity of delivery room resuscitation. Higher intensity of resuscitation was associated with increased risk of mortality. Conclusions The majority of MPT infants receive some level of delivery room resuscitation. Increased intensity of delivery room interventions was associated with prolonged respiratory and nutritional support, increased mortality, and a longer length of stay.
- Published
- 2018
- Full Text
- View/download PDF