Early Blood Gas Predictors of Bronchopulmonary Dysplasia in Extremely Low Gestational Age Newborns

Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measuremen...

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Published inInternational Journal of Pediatrics Vol. 2014; no. 2014; pp. 161 - 168
Main Authors Van Marter, Linda J., Allred, Elizabeth N., Leviton, Alan, Sriram, Sudhir, Laughon, Matthew, Bose, Carl, Shah, Bhavesh, Condie, Joy, Schreiber, Michael D., Batton, Daniel G.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Limiteds 01.01.2014
Hindawi Puplishing Corporation
Hindawi Publishing Corporation
Hindawi Limited
Wiley
Subjects
Analysis
Blood gas analysis
Bronchopulmonary dysplasia
Care and treatment
Development and progression
Diagnosis
United States
Online AccessGet full text

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Abstract Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any O2 on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results. In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions. Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD.
AbstractList Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any O2 on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results. In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions. Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD.
Aim . To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods . We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any O 2 on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results . In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions . Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD.
Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide information about the risk of bronchopulmonary dysplasia (BPD). Methods. We studied the association of extreme quartiles of blood gas measurements (hypoxemia, hyperoxemia, hypocapnea, and hypercapnea) in the first three postnatal days, with bronchopulmonary dysplasia, among 906 newborns, using multivariable models adjusting for potential confounders. We approximated NIH criteria by classifying severity of BPD on the basis of the receipt of any [O.sub.2] on postnatal day 28 and at 36 weeks PMA and assisted ventilation. Results. In models that did not adjust for ventilation, hypoxemia was associated with increased risk of severe BPD and very severe BPD, while infants who had hypercapnea were at increased risk of very severe BPD only. In contrast, infants who had hypocapnea were at reduced risk of severe BPD. Including ventilation for 14 or more days eliminated the associations with hypoxemia and with hypercapnea and made the decreased risk of very severe BPD statistically significant. Conclusions. Among ELGANs, recurrent/persistent blood gas abnormalities in the first three postnatal days convey information about the risk of severe and very severe BPD.
Audience Academic
Author Allred, Elizabeth N.
Shah, Bhavesh
Condie, Joy
Laughon, Matthew
Bose, Carl
Van Marter, Linda J.
Leviton, Alan
Sriram, Sudhir
Batton, Daniel G.
Schreiber, Michael D.
AuthorAffiliation 10 Department of Neurology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
5 Department of Pediatrics, Harvard Medical School, 220 Longwood Drive, Boston, MA 02115, USA
7 Division of Newborn Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
8 Department of Neurology, Harvard Medical School, 220 Longwood Drive, Boston, MA 02115, USA
9 Department of Biostatistics, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
1 Department of Pediatrics, University of Chicago, 5841 South Maryland Avenue MC 6060, Chicago, IL 60637, USA
6 Division of Newborn Medicine, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
3 Department of Pediatrics, Bay State Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA
2 Department of Pediatrics, Southern Illinois School of Medicine, 301 North 8th Street, Springfield, IL 62794, USA
4 Department of Pediatrics, University of North Carolina, 101 Manning Drive, Chapel Hill, NC 27
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CitedBy_id crossref_primary_10_1016_j_infbeh_2018_04_001
crossref_primary_10_1542_peds_2017_2719
crossref_primary_10_1080_17476348_2019_1648215
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Snippet Aim. To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide...
Aim . To determine among infants born before the 28th week of gestation to what extent blood gas abnormalities during the first three postnatal days provide...
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StartPage 161
SubjectTerms Analysis
Blood gas analysis
Bronchopulmonary dysplasia
Care and treatment
Development and progression
Diagnosis
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Title Early Blood Gas Predictors of Bronchopulmonary Dysplasia in Extremely Low Gestational Age Newborns
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