Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants

Erika Fernandez; Kristi L Watterberg; Roger G Faix; Bradley A Yoder; Michele C Walsh; Conra Backstrom Lacy; Karen A Osborne; Abhik Das; Douglas E Kendrick; Barbara J Stoll; Brenda B Poindexter; Abbot R Laptook; Kathleen A Kennedy; Kurt Schibler; Edward F Bell; Krisa P Van Meurs; Ivan D Frantz III; Ronald N Goldberg; Seetha Shankaran; Waldemar A Carlo; Richard A Ehrenkranz; Pablo J Sánchez; Rosemary D Higgins; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1055/s-0035-1547321

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Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants

Journal article

Open access

Peer reviewed

Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants

Erika Fernandez, Kristi L Watterberg, Roger G Faix, Bradley A Yoder, Michele C Walsh, Conra Backstrom Lacy, Karen A Osborne, Abhik Das, Douglas E Kendrick, Barbara J Stoll, …

American journal of perinatology, Vol.32(11), pp.1024-1030

09/2015

DOI: 10.1055/s-0035-1547321

PMCID: PMC4689139

PMID: 25825962

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https://doi.org/10.1055/s-0035-1547321View

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Abstract

We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

Blood Pressure

Prospective Studies

Respiration, Artificial - methods

Humans

Cardiovascular Diseases - therapy

Patient Discharge

Infant

Linear Models

Male

Infant, Premature, Diseases - therapy

Gestational Age

Critical Illness - mortality

Intensive Care Units, Neonatal

Infant, Premature

Perinatal Mortality

Female

Infant, Newborn

Details

Title: Subtitle: Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants
Creators: Erika Fernandez - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Kristi L Watterberg - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Roger G Faix - Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
Bradley A Yoder - Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
Michele C Walsh - Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
Conra Backstrom Lacy - Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Karen A Osborne - Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio
Abhik Das - Statistics and Epidemiology Unit, RTI International, Rockville, Maryland
Douglas E Kendrick - Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina
Barbara J Stoll - Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia
Brenda B Poindexter - Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
Abbot R Laptook - Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island
Kathleen A Kennedy - Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas
Kurt Schibler - Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
Edward F Bell - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Krisa P Van Meurs - Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children&s Hospital, Palo Alto, California
Ivan D Frantz III - Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts
Ronald N Goldberg - Department of Pediatrics, Duke University, Durham, North Carolina
Seetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, Michigan
Waldemar A Carlo - Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama
Richard A Ehrenkranz - Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
Pablo J Sánchez - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
Rosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, Maryland
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: American journal of perinatology, Vol.32(11), pp.1024-1030
DOI: 10.1055/s-0035-1547321
PMID: 25825962
PMCID: PMC4689139
ISSN: 0735-1631
eISSN: 1098-8785
Grant note: UG1 HD053089 / NICHD NIH HHS U10 HD27856 / NICHD NIH HHS UG1 HD040492 / NICHD NIH HHS UL1 TR000041 / NCATS NIH HHS U10 HD53089 / NICHD NIH HHS U10 HD027871 / NICHD NIH HHS U10 HD27880 / NICHD NIH HHS UL1 RR24979 / NCRR NIH HHS UL1 RR25744 / NCRR NIH HHS UG1 HD027880 / NICHD NIH HHS U10 HD27904 / NICHD NIH HHS U10 HD040492 / NICHD NIH HHS U10 HD27853 / NICHD NIH HHS U10 HD053089 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS U10 HD36790 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS UL1 TR001449 / NCATS NIH HHS UL1 TR000454 / NCATS NIH HHS UL1 RR24139 / NCRR NIH HHS UL1 RR25008 / NCRR NIH HHS U10 HD40492 / NICHD NIH HHS U10 HD021385 / NICHD NIH HHS UG1 HD034216 / NICHD NIH HHS UL1 RR024979 / NCRR NIH HHS UG1 HD021364 / NICHD NIH HHS U10 HD53119 / NICHD NIH HHS UG1 HD068278 / NICHD NIH HHS U10 HD053124 / NICHD NIH HHS UG1 HD027851 / NICHD NIH HHS U10 HD34216 / NICHD NIH HHS U10 HD27851 / NICHD NIH HHS U10 HD053119 / NICHD NIH HHS U10 HD53109 / NICHD NIH HHS UL1 RR025764 / NCRR NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD036790 / NICHD NIH HHS UL1 RR024139 / NCRR NIH HHS UL1 TR001108 / NCATS NIH HHS UL1 RR025008 / NCRR NIH HHS UL1 RR031977 / NCRR NIH HHS U10 HD21364 / NICHD NIH HHS UL1 RR25761 / NCRR NIH HHS U10 HD053109 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD27871 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD027853 / NICHD NIH HHS UL1 TR001085 / NCATS NIH HHS U10 HD40689 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS UL1 RR31977 / NCRR NIH HHS U10 HD027851 / NICHD NIH HHS U10 HD21385 / NICHD NIH HHS UL1 RR025761 / NCRR NIH HHS UG1 HD087229 / NICHD NIH HHS U10 HD034216 / NICHD NIH HHS UL1 RR025744 / NCRR NIH HHS UL1 RR25764 / NCRR NIH HHS U10 HD53124 / NICHD NIH HHS
Language: English
Date published: 09/2015
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093488802771

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