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Association of Continuous Opioids and/or Midazolam During Early Mechanical Ventilation with Survival and Sensorimotor Outcomes at Age 2 Years in Premature Infants: Results from the French Prospective National EPIPAGE 2 Cohort.
de Tristan, Marie-Amélie; Martin-Marchand, Laetitia; Roué, Jean-Michel; Anand, Kanwaljeet J S; Pierrat, Véronique; Tourneux, Pierre; Kuhn, Pierre; Milesi, Christophe; Benhammou, Valérie; Ancel, Pierre-Yves; Carbajal, Ricardo; Durrmeyer, Xavier.
Afiliação
  • de Tristan MA; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France.
  • Martin-Marchand L; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France.
  • Roué JM; Neonatal Intensive Care Unit, University Hospital of Brest, Brest, France.
  • Anand KJS; Department of Pediatrics, Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, CA.
  • Pierrat V; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France; Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.
  • Tourneux P; Neonatal Intensive Care Unit, CHU Amiens - University of Picardie Jules Verne, Amiens, France.
  • Kuhn P; Neonatal Intensive Care Unit, CHU Strasbourg, France, University of Strasbourg, INSERM Institute of Cellular and Integrative Neurosciences, Strasbourg, France.
  • Milesi C; Pediatric and Neonatal Intensive Care Unit, University Hospital of Montpellier, Montpellier, France.
  • Benhammou V; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France.
  • Ancel PY; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France.
  • Carbajal R; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France; Pediatric Emergency Department, Assistance Publique des Hôpitaux de Paris, Armand Trousseau Hospital, Paris, France; Sorbonne University, Faculty of Medecine, Paris, France.
  • Durrmeyer X; Center of Research in Epidemiology and Statistics, University of Paris, CRESS, INSERM, INRA, Paris, France; Neonatal Intensive Care Unit, Hospital Center Intercommunal Créteil, Créteil, France; University of Paris East Créteil, Faculty of Medecine, Mondor Biomedical Research Institute, Clinical Rese
J Pediatr ; 232: 38-47.e8, 2021 05.
Article em En | MEDLINE | ID: mdl-33395567
OBJECTIVE: To evaluate the association of early continuous infusions of opioids and/or midazolam with survival and sensorimotor outcomes at age 2 years in very premature infants who were ventilated. STUDY DESIGN: This national observational study included premature infants born before 32 weeks of gestation intubated within 1 hour after birth and still intubated at 24 hours from the French EPIPAGE 2 cohort. Infants only treated with bolus were excluded. Treated infants received continuous opioid and/or midazolam infusion started before 7 days of life and before the first extubation. Naive infants did not receive these treatments before the first extubation, or received them after the first week of life, or never received them. This study compared treated (n = 450) vs naive (n = 472) infants by using inverse probability of treatment weighting after multiple imputation in chained equations. The primary outcomes were survival and survival without moderate or severe neuromotor or sensory impairment at age 2 years. RESULTS: Survival at age 2 years was significantly higher in the treated group (92.5% vs 87.9%, risk difference, 4.7%; 95% CI, 0.3-9.1; P = .037), but treated and naive infants did not significantly differ for survival without moderate or severe neuromotor or sensory impairment (86.6% vs 81.3%; risk difference, 5.3%; 95% CI -0.3 to 11.0; P = .063). These results were confirmed by sensitivity analyses using 5 alternative models. CONCLUSIONS: Continuous opioid and/or midazolam infusions in very premature infants during initial mechanical ventilation that continued past 24 hours of life were associated with improved survival without any difference in moderate or severe sensorimotor impairments at age 2 years.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração Artificial / Midazolam / Recém-Nascido Prematuro / Transtornos do Neurodesenvolvimento / Analgésicos Opioides Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Estados Unidos
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração Artificial / Midazolam / Recém-Nascido Prematuro / Transtornos do Neurodesenvolvimento / Analgésicos Opioides Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn País/Região como assunto: Europa Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: França País de publicação: Estados Unidos