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Chronic lung disease in full-term infants: Characteristics and neonatal intensive care outcomes in infants referred to children's hospitals

Authors :
Michel, Mikhael
John P, Cleary
Isabella, Zaniletti
William E, Truog
John, Ibrahim
Robert, DiGeronimo
Alain, Cuna
Matthew J, Kielt
Carl H, Coghill
Shilpa, Vyas-Read
Sushmita, Yallapragada
William A, Engle
Rashmin C, Savani
Karna, Murthy
Joanne M, Lagatta
Source :
Pediatric pulmonologyREFERENCES. 57(9)
Publication Year :
2022

Abstract

To describe characteristics, outcomes, and risk factors for death or tracheostomy with home mechanical ventilation in full-term infants with chronic lung disease (CLD) admitted to regional neonatal intensive care units.This was a multicenter, retrospective cohort study of infants born ≥37 weeks of gestation in the Children's Hospitals Neonatal Consortium.Out of 67,367 full-term infants admitted in 2010-2016, 4886 (7%) had CLD based on receiving respiratory support at either 28 days of life or discharge. 3286 (67%) were still hospitalized at 28 days receiving respiratory support, with higher mortality risk than those without CLD (10% vs. 2%, p 0.001). A higher proportion received tracheostomy (13% vs. 0.3% vs. 0.4%, p 0.001) and gastrostomy (30% vs. 1.7% vs. 3.7%, p 0.001) compared to infants with CLD discharged home before 28 days and infants without CLD, respectively. The diagnoses and surgical procedures differed significantly between the two CLD subgroups. Small for gestational age, congenital pulmonary, airway, and cardiac anomalies and bloodstream infections were more common among infants with CLD who died or required tracheostomy with home ventilation (p 0.001). Invasive ventilation at 28 days was independently associated with death or tracheostomy and home mechanical ventilation (odds ratio 7.6, 95% confidence interval 5.9-9.6, p 0.0001).Full-term infants with CLD are at increased risk for morbidity and mortality. We propose a severity-based classification for CLD in full-term infants. Future work to validate this classification and its association with early childhood outcomes is necessary.

Details

ISSN :
10990496
Volume :
57
Issue :
9
Database :
OpenAIRE
Journal :
Pediatric pulmonologyREFERENCES
Accession number :
edsair.doi.dedup.....0d409bf68fe7e81b80c07fa7152fb96c