Survival and short-term respiratory outcomes of <750 g infants initially intubated with 2.0 mm vs. 2.5 mm endotracheal tubes

Abstract BACKGROUND Studies have demonstrated heterogeneity in association of pregnancy-induced hypertension (PIH) and respiratory outcomes or mortality in preterm infants, largely attributed to effect of gestation and antenatal steroids (survival bias). OBJECTIVES To comparatively evaluate mortality and short-term respiratory outcomes in preterm infants < 33 weeks GA born to mothers with and without PIH. DESIGN/METHODS This retrospective cohort study of preterm infants younger than 33 weeks’ gestation born between July 1, 2014 to June 30, 2016 was conducted at a tertiary academic hospital. Infants exposed to PIH (exposure) were matched to infants not exposed to PIH (control) in a 1:2 ratio, based on gestation, sex and antenatal steroid exposure status. The primary outcomes were respiratory index (RI), mortality and bronchopulmonary dysplasia (BPD). RI was defined as area under curve (AUC) for mean airway pressure and fraction inspired oxygen on invasive ventilation during first 72 hours. RESULTS Of 539 infants, 79 (exposure) were matched with 158 infants (control). Infants born to mothers with PIH had lower birth weight, more likely to delivered through caesarean section and less likely to exposed to chorioamnionitis compared to infants born to mothers without PIH. No differences in RI were noted in infants with (median 1854; IQR 186, 13901) or without PIH (median 1359; IQR 210, 11302) (P-value 0.63). On conditional regression analysis, PIH did not predict RI (adjusted risk 1.15; 95% C.I 0.69–1.90; P value 0.594). No association between PIH and death (OR 3.14; 95% C.I 0.76–13.0; P-value 0.11) was identified. PIH was significantly associated with BPD on univariate analysis (odds ratio (OR) 2.29; 95% C.I 1.02–5.17; P-value 0.046), but on regression analysis was not significant (adjusted OR 1.26; 95% C.I 0.38–4.19; P-value 0.7) (Table 1). CONCLUSION PIH was not associated with RI, mortality or BPD in this matched cohort. This contradicts from previous studies which may have been influenced with the survival bias. Further studies with larger samples are needed to confirm our results.

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Prophylactic Indomethacin Worsens Short-Term Respiratory Outcomes in Extremely Low-Birth-Weight Infants

American Journal of Perinatology ◽

10.1055/s-0033-1334449 ◽

2013 ◽

Vol 31 (01) ◽

pp. 061-068

Author(s):

Dipayan Chaudhuri ◽

Brian Li ◽

Sandesh Shivananda ◽

Sourabh Dutta ◽

Tapas Mondal

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Extremely Low Birth Weight ◽

Short Term ◽

Low Birth Weight Infants ◽

Respiratory Outcomes

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Retrospective Analysis of Short-Term Respiratory Outcomes of Three Different Steroids Used in Clinical Practice in Intubated Preterm Infants

American Journal of Perinatology ◽

10.1055/s-0039-1694004 ◽

2019 ◽

Vol 37 (14) ◽

pp. 1425-1431 ◽

Cited By ~ 1

Author(s):

Sfurti Nath ◽

Anne Marie Reynolds ◽

Satyan Lakshminrusimha ◽

ChangXing Ma ◽

Mark L. Hudak ◽

...

Keyword(s):

Preterm Infants ◽

Neonatal Intensive Care ◽

Low Dose ◽

Clinical Decision Making ◽

Quantitative Measure ◽

Short Term ◽

Neurodevelopmental Outcomes ◽

Respiratory Status ◽

Short Course ◽

Respiratory Outcomes

Objective This study aimed to compare short-term respiratory outcomes of three steroids (dexamethasone, hydrocortisone, and methylprednisolone) to facilitate extubation by improving respiratory status in preterm infants. Study Design This is a retrospective, single-center, cohort study of 98 intubated preterm infants ≤346/7 weeks' gestation, admitted to a 64-bed, level III neonatal intensive care unit at the Women & Children's Hospital of Buffalo, Buffalo, NY, between 2006 and 2012, who received a short course of low-dose steroids for lung disease after first week of life. Results Study infants received dexamethasone (34%), hydrocortisone (44%), or methylprednisolone (22%) based on clinical team preference. By day 7 after initiation of steroids, extubation occurred in 59, 44, and 41%, respectively, in infants on dexamethasone, hydrocortisone, and methylprednisolone (p = 0.3). The mean respiratory severity score (RSS = fraction of inspired oxygen × mean airway pressure), a quantitative measure of respiratory status, decreased by 44% for all infants and by 59% in the dexamethasone group by day 7. Conclusion Steroids improved short-term respiratory outcomes in all infants (RSS and extubation); by day 7, dexamethasone treatment was associated with the greatest decrease in RSS. Additional prospective, randomized trials of short-course low-dose steroids are warranted to substantiate these findings to guide clinical decision making and in evaluating differential steroid effects on long-term neurodevelopmental outcomes.

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Short Term Respiratory Outcomes in Children with Antibody Positive PIMS -TS

10.22541/au.161005487.70908822/v1 ◽

2021 ◽

Author(s):

Deevena Chinthala ◽

Chris Hine ◽

Pamela Dawson ◽

Steven Welch ◽

Scott Hackett ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Morbidity ◽

Short Term ◽

First Report ◽

Children's Hospital ◽

Respiratory Involvement ◽

The Uk ◽

Respiratory Outcomes ◽

Inflammatory Syndrome

Paediatric multisystem inflammatory syndrome: temporally associated with SARS-COV-2 (PIMS-TS) is a well described rare but severe COVID-19 related syndrome. PIMS-TS have been reported in children from geographical areas of high COVID-19 infection. Most children with PIMS-TS require management in an intensive care unit with variable respiratory involvement. Adults recovering from COVID-19 infection have been reported to suffer from respiratory morbidity but such outcomes are unknown in children. We present the first report of normal short term respiratory outcomes as measured by spirometry in children with SARS-COV-2 antibody positive, PIMS-TS syndrome managed at a specialist children’s hospital in the UK.

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The effects of a variable surfactant dose (poractant alfa) on short term respiratory outcomes in very and extremely preterm infants

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13494_306 ◽

2017 ◽

Vol 53 ◽

pp. 104-104

Keyword(s):

Preterm Infants ◽

Short Term ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Respiratory Outcomes

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Conceptual short-term memory (CSTM) supports core claims of Christiansen and Chater

Behavioral and Brain Sciences ◽

10.1017/s0140525x15000928 ◽

2016 ◽

Vol 39 ◽

Author(s):

Mary C. Potter

Keyword(s):

Working Memory ◽

Rapid Serial Visual Presentation ◽

Language Comprehension ◽

Short Term Memory ◽

Visual Presentation ◽

Long Term Memory ◽

Short Term ◽

Term Memory ◽

Use Of Knowledge

AbstractRapid serial visual presentation (RSVP) of words or pictured scenes provides evidence for a large-capacity conceptual short-term memory (CSTM) that momentarily provides rich associated material from long-term memory, permitting rapid chunking (Potter 1993; 2009; 2012). In perception of scenes as well as language comprehension, we make use of knowledge that briefly exceeds the supposed limits of working memory.

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