Craig R Wheeler1, Daniel Gagner1, Holly Stephens1, Amelia Kraus1, David Zurakowski2, Kevin G Friedman3, Juan C Ibla2, Ryan Callahan3, Diego Porras3, Philip T Levy4. 1. Department of Respiratory Care, Boston Children's Hospital, Boston, MA, USA. 2. Departments of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 3. Department of Cardiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. 4. Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, MA, USA. Philip.Levy@childrens.harvard.edu.
Abstract
OBJECTIVE: To identify risk factors associated with high-frequency ventilation (HFV) following definitive closure of the patent ductus arteriosus (PDA). METHODS: We performed a retrospective study of premature infants (<37 weeks) who were mechanically ventilated before and after surgical or transcatheter PDA closure. Primary outcome was HFV requirement within 24 h of procedure. Logistic regression was used to estimate clinical associations with post procedure HFV requirement. RESULTS: We identified 110 infants who were mechanically ventilated before PDA closure, of which 48 (44%) escalated to HFV within 24 h after closure. In the multivariable model, surgical ligation (OR 21.5, 95% CI 1.6-284), elevated Respiratory Severity Score (RSS) 1 h post-procedure (OR 1.78, 95% CI 1.07-2.99) and 12 h post-procedure (OR 2.12, 95% CI 1.37-3.26) were independent predictors of HFV. CONCLUSION: Surgical ligation and elevated RSS values over the first 12 h after PDA closure are risk factors for HFV.
OBJECTIVE: To identify risk factors associated with high-frequency ventilation (HFV) following definitive closure of the patent ductus arteriosus (PDA). METHODS: We performed a retrospective study of premature infants (<37 weeks) who were mechanically ventilated before and after surgical or transcatheter PDA closure. Primary outcome was HFV requirement within 24 h of procedure. Logistic regression was used to estimate clinical associations with post procedure HFV requirement. RESULTS: We identified 110 infants who were mechanically ventilated before PDA closure, of which 48 (44%) escalated to HFV within 24 h after closure. In the multivariable model, surgical ligation (OR 21.5, 95% CI 1.6-284), elevated Respiratory Severity Score (RSS) 1 h post-procedure (OR 1.78, 95% CI 1.07-2.99) and 12 h post-procedure (OR 2.12, 95% CI 1.37-3.26) were independent predictors of HFV. CONCLUSION: Surgical ligation and elevated RSS values over the first 12 h after PDA closure are risk factors for HFV.
Authors: Anas A Abu Hazeem; Matthew J Gillespie; Haley Thun; David Munson; Matthew C Schwartz; Yoav Dori; Jonathan J Rome; Andrew C Glatz Journal: Catheter Cardiovasc Interv Date: 2013-07-01 Impact factor: 2.692