학술논문
Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure.
Document Type
Article
Author
Source
Subject
*CONFIDENCE intervals
*EPIDEMIOLOGY
*EXTRACORPOREAL membrane oxygenation
*PREMATURE infants
*MULTIVARIATE analysis
*NITRIC acid
*RESEARCH funding
*RESPIRATORY insufficiency
*STATISTICS
*SURFACE active agents
*LOGISTIC regression analysis
*DATA analysis
*RANDOMIZED controlled trials
*PROPORTIONAL hazards models
*KAPLAN-Meier estimator
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Language
ISSN
0743-8346
Abstract
Objective:We conducted a post-hoc analysis of early inhaled nitric oxide (iNO)-randomized controlled trial data to identify associations pertinent to the management of moderate hypoxic respiratory failure in term/late preterm infants.Study design:Univariate and multivariate logistic regression analyses were used to determine risk factors for the progression of respiratory failure and extracorporeal membrane oxygenation (ECMO)/death.Result:Among the 299 enrolled infants, oxygenation index (OI) <20 at enrollment (odds ratio 0.52, confidence interval (CI) 0.27 to 0.97) and surfactant use before randomization (odds ratio 0.47, CI 0.24 to 0.91) were associated with decreased ECMO/death rates. Early surfactant use for respiratory distress syndrome, perinatal aspiration syndrome and pneumonia/sepsis was associated with lower risk of ECMO/death (P<0.001). Early iNO (OI 15 to 25) decreased the progression of respiratory failure to OI >30 (P=0.002) and to composite outcome of OI >30 or ECMO/death (P=0.02).Conclusion:This post-hoc analysis suggests that early use of surfactant and iNO in moderate respiratory failure is associated with improved outcomes. [ABSTRACT FROM AUTHOR]