Trajectory of Postnatal Oxygen Requirement in Extremely Preterm Infants.

IF 3.9 2区医学 Q1 PEDIATRICS Journal of Pediatrics Pub Date : 2024-11-20 DOI:10.1016/j.jpeds.2024.114414

Alan M Groves, Monica M Bennett, John Loyd, Reese H Clark, Veeral N Tolia

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Abstract

Objective: To describe the trends in percentage oxygen requirement and mode of respiratory support delivered to extremely premature infants in the 12 weeks after birth.

Study design: This is a retrospective study of extremely premature infants (≤27^6/7 weeks) discharged from neonatal intensive care units managed by Pediatrix Medical Group between January 1, 2016, and December 31, 2021. Demographic and daily clinical data (mode of respiratory support and fraction of inspired oxygen [FiO₂]) were extracted from the Pediatrix Clinical Data Warehouse.

Results: A total of 16 386 infants with a median gestational age of 25 weeks and birthweight of 765 g were included. There were 3808 (23.2%) infants who died. Of the cohort, 6019 (43.1%) infants who survived to 36 weeks' gestation had bronchopulmonary dysplasia. Median FiO₂ at all gestations followed a biphasic pattern with a peak on day of life 1, reduction to a nadir by day 4 to 5, and an increase to a second peak around day 14. Infants born at lower gestational ages had a higher median FiO₂ at each time point. At lower gestations, there were higher proportions of infants receiving mechanical ventilation and a later introduction of noninvasive modes.

Conclusions: Extremely premature infants show a consistent biphasic pattern in percentage of supplemental oxygen required after birth.

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极早产儿出生后的需氧量轨迹。

研究目的描述极早产儿出生后 12 周内的氧气需求百分比和呼吸支持方式的变化趋势：这是一项回顾性研究，研究对象为 2016 年 1 月 1 日至 2021 年 12 月 31 日期间从 Pediatrix 医疗集团管理的新生儿重症监护病房出院的极早产儿（≤27+6 周）。人口统计学和日常临床数据（呼吸支持模式和吸氧分数 [FiO2]）均从 Pediatrix 临床数据仓库中提取：共纳入 16,386 名婴儿，中位胎龄为 25 周，出生体重为 765 克。3808名（23.2%）婴儿死亡。6,019名（43.1%）妊娠36周以内的存活婴儿患有支气管肺发育不良（BPD）。所有妊娠期的血氧饱和度中值均呈双相模式，在出生后第 1 天达到峰值，第 4 至 5 天降至最低点，第 14 天左右升至第二个峰值。低胎龄出生的婴儿在每个时间点的 FiO2 中位数都较高。胎龄越小的婴儿接受机械通气的比例越高，采用无创通气模式的时间也越晚：结论：极早产儿出生后需要补充氧气的比例呈现出一致的双相模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.