Journal article
Developmental outcomes of very preterm infants with tracheostomies
The Journal of pediatrics, Vol.164(6), pp.1303-1310.e2
06/2014
DOI: 10.1016/j.jpeds.2013.12.014
PMCID: PMC4035374
PMID: 24472229
Abstract
To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy.
Retrospective cohort study from 16 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network over 10 years (2001-2011). Infants who survived to at least 36 weeks (N = 8683), including 304 infants with tracheostomies, were studied. Primary outcome was death or neurodevelopmental impairment (NDI; a composite of ≥1 of developmental delay, neurologic impairment, profound hearing loss, severe visual impairment) at a corrected age of 18-22 months. Outcomes were compared using multiple logistic regression. We assessed the impact of timing by comparing outcomes of infants who underwent tracheostomy before and after 120 days of life.
Tracheostomies were associated with all neonatal morbidities examined and with most adverse neurodevelopmental outcomes. Death or NDI occurred in 83% of infants with tracheostomies and 40% of those without (OR adjusted for center 7.0, 95% CI 5.2-9.5). After adjustment for potential confounders, odds of death or NDI remained higher (OR 3.3, 95% CI 2.4-4.6), but odds of death alone were lower (OR 0.4, 95% CI 0.3-0.7) among infants with tracheostomies. Death or NDI was lower in infants who received their tracheostomies before, rather than after, 120 days of life (aOR 0.5, 95% CI 0.3-0.9).
Tracheostomy in preterm infants is associated with adverse developmental outcomes and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population.
Details
- Title: Subtitle
- Developmental outcomes of very preterm infants with tracheostomies
- Creators
- Sara B DeMauro - Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, The University of Pennsylvania, Philadelphia, PA. Electronic address: DeMauro@email.chop.eduJo Ann D'Agostino - Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PACarla Bann - Research Triangle Institute, Research Triangle Park, NCJudy Bernbaum - Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, The University of Pennsylvania, Philadelphia, PAMarsha Gerdes - Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, The University of Pennsylvania, Philadelphia, PAEdward F Bell - Department of Pediatrics, University of Iowa, Iowa City, IAWaldemar A Carlo - Department of Pediatrics, University of Alabama, Birmingham, ALCarl T D'Angio - Research Triangle Institute, Research Triangle Park, NCAbhik Das - Department of Pediatrics, The University of Rochester, Rochester, NYRosemary Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network, Rockville, MDSusan R Hintz - Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CAAbbot R Laptook - Department of Pediatrics, Brown University, Providence, RIGirija Natarajan - Department of Pediatrics, Wayne State University School of Medicine, Detroit, MILeif Nelin - Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OHBrenda B Poindexter - Department of Pediatrics, Indiana University, Indianapolis, INPablo J Sanchez - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TXSeetha Shankaran - Department of Pediatrics, Wayne State University School of Medicine, Detroit, MIBarbara J Stoll - Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GAWilliam Truog - Department of Pediatrics, Children's Mercy Hospital, Kansas City, MOKrisa P Van Meurs - Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CABetty Vohr - Department of Pediatrics, Brown University, Providence, RIMichele C Walsh - Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OHHaresh Kirpalani - Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, The University of Pennsylvania, Philadelphia, PAEunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.164(6), pp.1303-1310.e2
- DOI
- 10.1016/j.jpeds.2013.12.014
- PMID
- 24472229
- PMCID
- PMC4035374
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Grant note
- U10 HD27856 / NICHD NIH HHS U10 HD68284 / NICHD NIH HHS M01 RR16587 / NCRR NIH HHS UL1 TR93 / NCATS NIH HHS U10 HD27880 / NICHD NIH HHS U10 HD27904 / NICHD NIH HHS UL1 TR77 / NCATS NIH HHS M01 RR39 / NCRR NIH HHS M01 RR32 / NCRR NIH HHS M01 RR7122 / NCRR NIH HHS U10 HD27853 / NICHD NIH HHS M01 RR70 / NCRR NIH HHS U10 HD040689 / NICHD NIH HHS UL1 TR142 / NCATS NIH HHS U10 HD36790 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS M01 RR8084 / NCRR NIH HHS U10 HD40498 / NICHD NIH HHS UL1 RR24128 / NCRR NIH HHS U10 HD068284 / NICHD NIH HHS M01 RR44 / NCRR NIH HHS U10 HD40492 / NICHD NIH HHS U10 HD021385 / NICHD NIH HHS UG1 HD034216 / NICHD NIH HHS U10 HD040461 / NICHD NIH HHS M01 RR80 / NCRR NIH HHS U10 HD34216 / NICHD NIH HHS U10 HD27851 / NICHD NIH HHS UL1 TR454 / NCATS NIH HHS UL1 TR6 / NCATS NIH HHS U10 HD68244 / NICHD NIH HHS M01 RR125 / NCRR NIH HHS U10 HD21397 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD068244 / NICHD NIH HHS U10 HD68278 / NICHD NIH HHS UL1 TR42 / NCATS NIH HHS U10 HD21364 / NICHD NIH HHS U10 HD053109 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD27871 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD40689 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD027851 / NICHD NIH HHS U10 HD40461 / NICHD NIH HHS UL1 RR25747 / NCRR NIH HHS U10 HD21385 / NICHD NIH HHS M01 RR633 / NCRR NIH HHS UG1 HD087229 / NICHD NIH HHS M01 RR750 / NCRR NIH HHS U10 HD034216 / NICHD NIH HHS M01 RR6022 / NCRR NIH HHS U10 HD40521 / NICHD NIH HHS U10 HD21373 / NICHD NIH HHS U10 HD068263 / NICHD NIH HHS M01 RR30 / NCRR NIH HHS
- Language
- English
- Date published
- 06/2014
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093330702771
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