Risk factors and clinical outcomes of pulmonary interstitial emphysema in extremely low birth weight infants

R P Verma; S Chandra; R Niwas; E Komaroff

doi:10.1038/sj.jp.7211456

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Risk factors and clinical outcomes of pulmonary interstitial emphysema in extremely low birth weight infants

Journal article

Open access

Peer reviewed

Risk factors and clinical outcomes of pulmonary interstitial emphysema in extremely low birth weight infants

R P Verma, S Chandra, R Niwas and E Komaroff

Journal of perinatology, Vol.26(3), pp.197-200

03/2006

DOI: 10.1038/sj.jp.7211456

PMID: 16493434

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Abstract

We studied the ante- and postnatal risk factors and clinical outcomes associated with pulmonary interstitial emphysema (PIE) in extremely low birth weight infants (ELBW, <1000 g at birth) in the present era of tocolytics, antenatal steroid and postnatal surfactant administration. This was a retrospective case-controlled study of all ELBW admitted consecutively during a designated study-period in a level III nursery. Data were analyzed by performing univariate and multivariate analysis as applicable. Infants with PIE had lower 1 and 5 min Apgar scores (P=0.04 and 0.003 respectively), increased surfactant utilization (P=0.004), higher maximum inspired oxygen concentration (P=0.04) and mean airway pressure administration (P=0.02) during the first week of life, and increased neonatal mortality (P=0.01). They received higher antenatal doses of magnesium sulfate (MgSO(4)) (P=0.02). 56% of infants with PIE were exposed to more than 10 g of MgSO(4) (Mg10), compared to 15% in non-PIE group (P=0.01). The multivariate logistic regression analysis including significant co-variates revealed an independent association between Mg10 and PIE (P=0.01, Odds ratio 19.8, 95% CI 1.5-263). Pulmonary interstitial emphysema is associated with increased mortality in ELBW infants. Mg10 is an independent risk factor for PIE in this population.

Apgar Score

Case-Control Studies

Female

Follow-Up Studies

Humans

Incidence

Infant, Newborn

Infant, Very Low Birth Weight

Intensive Care Units, Neonatal

Male

Oxygen - therapeutic use

Probability

Pulmonary Emphysema - epidemiology

Pulmonary Emphysema - etiology

Pulmonary Emphysema - physiopathology

Respiration, Artificial - methods

Respiratory Distress Syndrome, Newborn - diagnosis

Respiratory Distress Syndrome, Newborn - therapy

Retrospective Studies

Risk Assessment

Survival Rate

Treatment Outcome

Details

Title: Subtitle: Risk factors and clinical outcomes of pulmonary interstitial emphysema in extremely low birth weight infants
Creators: R P Verma - Stony Brook School
S Chandra - Case Western Reserve University
R Niwas - John H. Stroger, Jr. Hospital of Cook County
E Komaroff - Stony Brook University
Resource Type: Journal article
Publication Details: Journal of perinatology, Vol.26(3), pp.197-200
DOI: 10.1038/sj.jp.7211456
PMID: 16493434
ISSN: 0743-8346
eISSN: 1476-5543
Grant note: 5-M01-RR-10710 / NCRR NIH HHS
Language: English
Date published: 03/2006
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984354043002771

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