OBJECTIVE: To examine the relationships between intensity of delivery room resuscitation and short- and long-term outcomes of very low birth weight infants enrolled in the Caffeine for Apnea of Prematurity (CAP) Trial. STUDY DESIGN: The CAP Trial enrolled 2006 infants with birthweights between 500 and 1250 g who were eligible for caffeine therapy. All levels of delivery room resuscitation were recorded in study participants. We divided infants in 4 groups of increasing intensity of resuscitation: minimal, n = 343; bag-mask ventilation, n = 372; endotracheal intubation, n = 1205; and cardiopulmonary resuscitation (chest compressions/epinephrine), n = 86. We used multivariable logistic regression models to compare outcomes across the 4 groups. RESULTS: The observed rates of death or disability, death, cerebral palsy, cognitive deficit, and hearing loss at 18 months increased with higher levels of resuscitation. Risk of bronchopulmonary dysplasia, severe retinopathy of prematurity, and brain injury also increased with higher levels of resuscitation. Adjustment for prognostic variables reduced the differences between the groups for most outcomes. Only the adjusted rates of bronchopulmonary dysplasia and severe retinopathy remained significantly higher after more intense resuscitation. CONCLUSIONS: In CAP Trial participants, the risk of death or neurodevelopmental disability at 18 months did not increase substantially with increasing intensity of delivery room resuscitation.
RCT Entities:
OBJECTIVE: To examine the relationships between intensity of delivery room resuscitation and short- and long-term outcomes of very low birth weight infants enrolled in the Caffeine for Apnea of Prematurity (CAP) Trial. STUDY DESIGN: The CAP Trial enrolled 2006 infants with birthweights between 500 and 1250 g who were eligible for caffeine therapy. All levels of delivery room resuscitation were recorded in study participants. We divided infants in 4 groups of increasing intensity of resuscitation: minimal, n = 343; bag-mask ventilation, n = 372; endotracheal intubation, n = 1205; and cardiopulmonary resuscitation (chest compressions/epinephrine), n = 86. We used multivariable logistic regression models to compare outcomes across the 4 groups. RESULTS: The observed rates of death or disability, death, cerebral palsy, cognitive deficit, and hearing loss at 18 months increased with higher levels of resuscitation. Risk of bronchopulmonary dysplasia, severe retinopathy of prematurity, and brain injury also increased with higher levels of resuscitation. Adjustment for prognostic variables reduced the differences between the groups for most outcomes. Only the adjusted rates of bronchopulmonary dysplasia and severe retinopathy remained significantly higher after more intense resuscitation. CONCLUSIONS: In CAP Trial participants, the risk of death or neurodevelopmental disability at 18 months did not increase substantially with increasing intensity of delivery room resuscitation.
Authors: Elizabeth E Foglia; Erik A Jensen; Myra H Wyckoff; Taylor Sawyer; Alexis Topjian; Sarah J Ratcliffe Journal: Resuscitation Date: 2020-01-23 Impact factor: 5.262
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Authors: Vishal Kapadia; Ju Lee Oei; Neil Finer; Wade Rich; Yacov Rabi; Ian M Wright; Denise Rook; Marijn J Vermeulen; William O Tarnow-Mordi; John P Smyth; Kei Lui; Steven Brown; Ola D Saugstad; Maximo Vento Journal: Resuscitation Date: 2021-08-20 Impact factor: 6.251
Authors: R L Figueira; F L Gonçalves; A L Simões; C A Bernardino; L S Lopes; O Castro E Silva; L Sbragia Journal: Braz J Med Biol Res Date: 2016-06-23 Impact factor: 2.590
Authors: Jeroen J van Vonderen; Henriëtte A van Zanten; Kim Schilleman; Stuart B Hooper; Marcus J Kitchen; Ruben S G M Witlox; Arjan B Te Pas Journal: Front Pediatr Date: 2016-04-18 Impact factor: 3.418
Authors: Daynia E Ballot; Faustine Agaba; Peter A Cooper; Victor A Davies; Tanusha Ramdin; Lea Chirwa; David Rakotsoane; Lethile Madzudzo Journal: Matern Health Neonatol Perinatol Date: 2017-05-30