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Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years.

Abstract Assisted ventilation for extremely preterm infants (<28 weeks of gestation) has become less invasive, but it is unclear whether such developments in care are associated with improvements in short-term or long-term lung function. We compared changes over time in the use of assisted ventilation and oxygen therapy during the newborn period and in lung function at 8 years of age in children whose birth was extremely premature.
PMID
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Authors

Mayor MeshTerms

Forced Expiratory Volume

Infant, Extremely Premature

Respiration, Artificial

Vital Capacity

Keywords
Journal Title the new england journal of medicine
Publication Year Start




PMID- 28745986
OWN - NLM
STAT- MEDLINE
DA  - 20170726
DCOM- 20170801
LR  - 20170801
IS  - 1533-4406 (Electronic)
IS  - 0028-4793 (Linking)
VI  - 377
IP  - 4
DP  - 2017 Jul 27
TI  - Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years.
PG  - 329-337
LID - 10.1056/NEJMoa1700827 [doi]
AB  - BACKGROUND: Assisted ventilation for extremely preterm infants (&lt;28 weeks of
      gestation) has become less invasive, but it is unclear whether such developments 
      in care are associated with improvements in short-term or long-term lung
      function. We compared changes over time in the use of assisted ventilation and
      oxygen therapy during the newborn period and in lung function at 8 years of age
      in children whose birth was extremely premature. METHODS: We conducted
      longitudinal follow-up of all survivors of extremely preterm birth who were born 
      in Victoria, Australia, in three periods - the years 1991 and 1992 (225 infants),
      1997 (151 infants), and 2005 (170 infants). Perinatal data were collected
      prospectively, including data on the duration and type of assisted ventilation
      provided, the duration of oxygen therapy, and oxygen requirements at 36 weeks of 
      age. Expiratory airflow was measured at 8 years of age, and values were converted
      to z scores for age, height, ethnic group, and sex. RESULTS: The duration of
      assisted ventilation rose substantially over time, with a large increase in the
      duration of nasal continuous positive airway pressure. Despite the increase in
      the use of less invasive ventilation over time, the duration of oxygen therapy
      and the rate of oxygen dependence at 36 weeks rose, and airflows at 8 years of
      age were worse in 2005 than in earlier periods. For instance, for 2005 versus
      1991-1992, the mean difference in the z scores for the ratio of forced expiratory
      volume in 1 second to forced vital capacity was -0.75 (95% confidence interval
      [CI], -1.07 to -0.44; P&lt;0.001), and for 2005 versus 1997 the mean difference was 
      -0.53 (95% CI, -0.86 to -0.19; P=0.002). CONCLUSIONS: Despite substantial
      increases in the use of less invasive ventilation after birth, there was no
      significant decline in oxygen dependence at 36 weeks and no significant
      improvement in lung function in childhood over time. (Funded by the National
      Health and Medical Research Council of Australia and the Victorian Government's
      Operational Infrastructure Support Program.).
FAU - Doyle, Lex W
AU  - Doyle LW
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
FAU - Carse, Elizabeth
AU  - Carse E
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
FAU - Adams, Anne-Marie
AU  - Adams AM
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
FAU - Ranganathan, Sarath
AU  - Ranganathan S
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
FAU - Opie, Gillian
AU  - Opie G
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
FAU - Cheong, Jeanie L Y
AU  - Cheong JLY
AD  - From Neonatal Services, Royal Women's Hospital (L.W.D., J.L.Y.C.), the
      Departments of Obstetrics and Gynaecology (L.W.D., J.L.Y.C.) and Paediatrics
      (L.W.D., S.R.), University of Melbourne, Clinical Sciences (L.W.D., J.L.Y.C.) and
      Infection and Immunity (A.-M.A., S.R.), Murdoch Childrens Research Institute,
      Newborn Services, Monash Medical Centre (E.C.), Respiratory and Sleep Medicine,
      Royal Children's Hospital (A.-M.A., S.R.), and Neonatal Services, Mercy Hospital 
      for Women (G.O.) - all in Melbourne, VIC, Australia.
CN  - Victorian Infant Collaborative Study Group
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - N Engl J Med
JT  - The New England journal of medicine
JID - 0255562
RN  - 0 (Glucocorticoids)
SB  - AIM
SB  - IM
CIN - N Engl J Med. 2017 Jul 27;377(4):386-388. PMID: 28745997
MH  - Bronchopulmonary Dysplasia/prevention &amp; control
MH  - Child
MH  - Continuous Positive Airway Pressure/utilization
MH  - Female
MH  - Follow-Up Studies
MH  - *Forced Expiratory Volume
MH  - Glucocorticoids/therapeutic use
MH  - High-Frequency Ventilation
MH  - Humans
MH  - *Infant, Extremely Premature
MH  - Infant, Newborn
MH  - Intermittent Positive-Pressure Ventilation
MH  - Male
MH  - Oxygen Inhalation Therapy/utilization
MH  - *Respiration, Artificial
MH  - Respiratory Distress Syndrome, Newborn/*therapy
MH  - Survival Rate
MH  - Time Factors
MH  - *Vital Capacity
IR  - Anderson P
FIR - Anderson, Peter
IR  - Burnett A
FIR - Burnett, Alice
IR  - Callanan C
FIR - Callanan, Catherine
IR  - Charlton MP
FIR - Charlton, Margaret P
IR  - Davis N
FIR - Davis, Noni
IR  - Duff J
FIR - Duff, Julianne
IR  - Hutchinson E
FIR - Hutchinson, Esther
IR  - Hayes M
FIR - Hayes, Marie
IR  - Kelly E
FIR - Kelly, Elaine
IR  - Lee KJ
FIR - Lee, Katherine J
IR  - McDonald M
FIR - McDonald, Marion
IR  - Roberts G
FIR - Roberts, Gehan
IR  - Watkins A
FIR - Watkins, Andrew
IR  - Williamson A
FIR - Williamson, Amanda
IR  - Woods H
FIR - Woods, Heather
EDAT- 2017/07/27 06:00
MHDA- 2017/08/02 06:00
CRDT- 2017/07/27 06:00
AID - 10.1056/NEJMoa1700827 [doi]
PST - ppublish
SO  - N Engl J Med. 2017 Jul 27;377(4):329-337. doi: 10.1056/NEJMoa1700827.