Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

Juliann M Di Fiore; Richard J Martin; Hong Li; Nathan Morris; Waldemar A Carlo; Neil Finer; Michele Walsh; SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

doi:10.1016/j.jpeds.2017.01.057

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Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

Journal article

Peer reviewed

Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

Juliann M Di Fiore, Richard J Martin, Hong Li, Nathan Morris, Waldemar A Carlo, Neil Finer, Michele Walsh and SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

The Journal of pediatrics, Vol.186, pp.49-56.e1

07/2017

DOI: 10.1016/j.jpeds.2017.01.057

PMCID: PMC5484739

PMID: 28279433

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Abstract

To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial. Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5 minutes) were documented in 1054 infants of 24 -27 weeks of gestation while receiving supplemental oxygen during the first 3 days of life. Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA. Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival. ClinicalTrials.gov: NCT00233324.

Cohort Studies

Continuous Positive Airway Pressure

Female

Humans

Hypoxia - metabolism

Hypoxia - mortality

Hypoxia - therapy

Infant, Extremely Premature

Infant, Newborn

Infant, Premature, Diseases - metabolism

Infant, Premature, Diseases - mortality

Infant, Premature, Diseases - therapy

Infant, Small for Gestational Age

Male

Oxygen Inhalation Therapy

Pulmonary Surfactants - therapeutic use

Survival Rate

Details

Title: Subtitle: Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort
Creators: Juliann M Di Fiore - Case Western Reserve University
Richard J Martin - Case Western Reserve University
Hong Li - Case Western Reserve University
Nathan Morris - Case Western Reserve University
Waldemar A Carlo - University of Alabama at Birmingham
Neil Finer - University of California, San Diego
Michele Walsh - Case Western Reserve University
SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network
Contributors: Edward F Bell (Contributor) - University of Iowa, Neonatology
Jonathan M Klein (Contributor) - University of Iowa, Neonatology
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.186, pp.49-56.e1
DOI: 10.1016/j.jpeds.2017.01.057
PMID: 28279433
PMCID: PMC5484739
ISSN: 0022-3476
eISSN: 1097-6833
Grant note: UG1 HD053089 / NICHD NIH HHS UG1 HD040492 / NICHD NIH HHS UG1 HD027904 / NICHD NIH HHS U10 HD027871 / NICHD NIH HHS M01 RR008084 / NCRR NIH HHS M01 RR016587 / NCRR NIH HHS UG1 HD027880 / NICHD NIH HHS U10 HD040498 / NICHD NIH HHS M01 RR000080 / NCRR NIH HHS M01 RR000997 / NCRR NIH HHS U10 HD021373 / NICHD NIH HHS U10 HD040492 / NICHD NIH HHS U10 HD040521 / NICHD NIH HHS U10 HD053089 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS UL1 TR001449 / NCATS NIH HHS UL1 TR000454 / NCATS NIH HHS M01 RR007122 / NCRR NIH HHS U10 HD021385 / NICHD NIH HHS UG1 HD034216 / NICHD NIH HHS U10 HD040461 / NICHD NIH HHS UL1 RR024979 / NCRR NIH HHS UG1 HD021364 / NICHD NIH HHS UG1 HD027853 / NICHD NIH HHS UG1 HD068278 / NICHD NIH HHS U10 HD053124 / NICHD NIH HHS UG1 HD027851 / NICHD NIH HHS R03 HD078528 / NICHD NIH HHS U10 HD053119 / NICHD NIH HHS M01 RR006022 / NCRR NIH HHS M01 RR000054 / NCRR NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD021397 / NICHD NIH HHS U10 HD036790 / NICHD NIH HHS UL1 RR024139 / NCRR NIH HHS UL1 RR025008 / NCRR NIH HHS M01 RR000044 / NCRR NIH HHS U10 HD053109 / NICHD NIH HHS UG1 HD087226 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD027853 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD027851 / NICHD NIH HHS M01 RR000070 / NCRR NIH HHS UG1 HD087229 / NICHD NIH HHS U10 HD034216 / NICHD NIH HHS UL1 RR025744 / NCRR NIH HHS M01 RR000064 / NCRR NIH HHS
Language: English
Date published: 07/2017
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984353942302771

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