Ariel A Salas1, Waldemar A Carlo2, Barbara T Do3, Edward F Bell4, Abhik Das3, Krisa P Van Meurs5, Brenda B Poindexter6, Seetha Shankaran7, Noelle Younge8, Kristi L Watterberg9, Rosemary D Higgins10. 1. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. Electronic address: asalas@peds.uab.edu. 2. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 3. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC. 4. Department of Pediatrics, University of Iowa, Iowa City, IA. 5. Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA. 6. Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA. 7. Department of Pediatrics, Wayne State University, Detroit, MI. 8. Department of Pediatrics, Duke University, Durham, NC. 9. University of New Mexico Health Sciences Center, Albuquerque, NM. 10. National Institute of Child Health and Human Development, Bethesda, MD; Department of Global and Community Health, George Mason University, Fairfax, VA.
Abstract
OBJECTIVE: To evaluate the effects of early treatment with continuous positive airway pressure (CPAP) on nutritional intake and in-hospital growth rates of extremely preterm (EPT) infants. STUDY DESIGN: EPT infants (240/7-276/7 weeks of gestation) enrolled in the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) were included. EPT infants who died before 36 weeks of postmenstrual age (PMA) were excluded. The growth rates from birth to 36 weeks of PMA and follow-up outcomes at 18-22 months corrected age of EPT infants randomized at birth to either early CPAP (intervention group) or early intubation for surfactant administration (control group) were analyzed. RESULTS: Growth data were analyzed for 810 of 1316 infants enrolled in SUPPORT (414 in the intervention group, 396 in the control group). The median gestational age was 26 weeks, and the mean birth weight was 839 g. Baseline characteristics, total nutritional intake, and in-hospital comorbidities were not significantly different between the 2 groups. In a regression model, growth rates between birth and 36 weeks of PMA, as well as growth rates during multiple intervals from birth to day 7, days 7-14, days 14-21, days 21-28, day 28 to 32 weeks PMA, and 32-36 weeks PMA did not differ between treatment groups. Independent of treatment group, higher growth rates from day 21 to day 28 were associated with a lower risk of having a Bayley-III cognitive score <85 at 18-22 months corrected age (P = .002). CONCLUSIONS: EPT infants randomized to early CPAP did not have higher in-hospital growth rates than infants randomized to early intubation.
OBJECTIVE: To evaluate the effects of early treatment with continuous positive airway pressure (CPAP) on nutritional intake and in-hospital growth rates of extremely preterm (EPT) infants. STUDY DESIGN: EPT infants (240/7-276/7 weeks of gestation) enrolled in the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) were included. EPT infants who died before 36 weeks of postmenstrual age (PMA) were excluded. The growth rates from birth to 36 weeks of PMA and follow-up outcomes at 18-22 months corrected age of EPT infants randomized at birth to either early CPAP (intervention group) or early intubation for surfactant administration (control group) were analyzed. RESULTS: Growth data were analyzed for 810 of 1316 infants enrolled in SUPPORT (414 in the intervention group, 396 in the control group). The median gestational age was 26 weeks, and the mean birth weight was 839 g. Baseline characteristics, total nutritional intake, and in-hospital comorbidities were not significantly different between the 2 groups. In a regression model, growth rates between birth and 36 weeks of PMA, as well as growth rates during multiple intervals from birth to day 7, days 7-14, days 14-21, days 21-28, day 28 to 32 weeks PMA, and 32-36 weeks PMA did not differ between treatment groups. Independent of treatment group, higher growth rates from day 21 to day 28 were associated with a lower risk of having a Bayley-III cognitive score <85 at 18-22 months corrected age (P = .002). CONCLUSIONS: EPT infants randomized to early CPAP did not have higher in-hospital growth rates than infants randomized to early intubation.
Authors: Jane E Harding; Barbara E Cormack; Tanith Alexander; Jane M Alsweiler; Frank H Bloomfield Journal: Lancet Date: 2017-04-22 Impact factor: 79.321
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Authors: Waldemar A Carlo; Neil N Finer; Michele C Walsh; Wade Rich; Marie G Gantz; Abbot R Laptook; Bradley A Yoder; Roger G Faix; Abhik Das; W Kenneth Poole; Kurt Schibler; Nancy S Newman; Namasivayam Ambalavanan; Ivan D Frantz; Anthony J Piazza; Pablo J Sánchez; Brenda H Morris; Nirupama Laroia; Dale L Phelps; Brenda B Poindexter; C Michael Cotten; Krisa P Van Meurs; Shahnaz Duara; Vivek Narendran; Beena G Sood; T Michael O'Shea; Edward F Bell; Richard A Ehrenkranz; Kristi L Watterberg; Rosemary D Higgins Journal: N Engl J Med Date: 2010-05-16 Impact factor: 91.245