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Outcomes of delivery room resuscitation of bradycardic preterm infants: A retrospective cohort study of randomised trials of high vs low initial oxygen concentration and an individual patient data analysis.
Kapadia, Vishal; Oei, Ju Lee; Finer, Neil; Rich, Wade; Rabi, Yacov; Wright, Ian M; Rook, Denise; Vermeulen, Marijn J; Tarnow-Mordi, William O; Smyth, John P; Lui, Kei; Brown, Steven; Saugstad, Ola D; Vento, Maximo.
Afiliación
  • Kapadia V; Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center at Dallas, TX, USA. Electronic address: Vishal.kapadia@utsouthwestern.edu.
  • Oei JL; Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia; NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.
  • Finer N; Department of Neonatology, University of California San Diego, San Diego, CA, USA.
  • Rich W; Department of Neonatology, University of California San Diego, San Diego, CA, USA.
  • Rabi Y; University of Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Alberta, Canada.
  • Wright IM; Illawarra Health and Medical Research Institute and Graduate Medicine, The University of Wollongong, Wollongong, NSW, Australia.
  • Rook D; Department of Pediatrics, Division of Neonatology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.
  • Vermeulen MJ; Department of Pediatrics, Division of Neonatology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands.
  • Tarnow-Mordi WO; NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia.
  • Smyth JP; Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia.
  • Lui K; Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia.
  • Brown S; Parkland Health and Hospital System, Dallas, TX, USA.
  • Saugstad OD; Department of Pediatric Research, University of Oslo, Oslo University Hospital, Norway; Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinberg School of Medicine, USA.
  • Vento M; Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.
Resuscitation ; 167: 209-217, 2021 10.
Article en En | MEDLINE | ID: mdl-34425156
OBJECTIVE: To determine whether hospital mortality (primary outcome) is associated with duration of bradycardia without chest compressions during delivery room (DR) resuscitation in a retrospective cohort study of randomized controlled trials (RCTs) in preterm infants assigned low versus high initial oxygen concentration. METHODS: Medline and EMBASE were searched from 01/01/1990 to 12/01/2020. RCTs of low vs high initial oxygen concentration which recorded serial heart rate (HR) and oxygen saturation (SpO2) during resuscitation of infants <32 weeks gestational age were eligible. Individual patient level data were requested from the authors. Newborns receiving chest compressions in the DR and those with no recorded HR in the first 2 min after birth were excluded. Prolonged bradycardia (PB) was defined as HR < 100 bpm for ≥2 min. Individual patient data analysis and pooled data analysis were conducted. RESULTS: Data were collected from 720 infants in 8 RCTs. Neonates with PB had higher odds of hospital death before [OR 3.8 (95% CI 1.5, 9.3)] and after [OR 1.7 (1.2, 2.5)] adjusting for potential confounders. Bradycardia occurred in 58% infants, while 38% had PB. Infants with bradycardia were more premature and had lower birth weights. The incidence of bradycardia in infants resuscitated with low (≤30%) and high (≥60%) oxygen was similar. Neonates with both, PB and SpO2 < 80% at 5 min after birth had higher odds of hospital mortality. [OR 18.6 (4.3, 79.7)]. CONCLUSION: In preterm infants who did not receive chest compressions in the DR, prolonged bradycardia is associated with hospital mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxígeno / Bradicardia Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Resuscitation Año: 2021 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxígeno / Bradicardia Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Resuscitation Año: 2021 Tipo del documento: Article Pais de publicación: Irlanda