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Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure. J Perinatol 2013 Dec;33(12):944-9

Date

07/23/2013

Pubmed ID

23867958

Pubmed Central ID

PMC3841912

DOI

10.1038/jp.2013.83

Scopus ID

2-s2.0-84888641110 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

OBJECTIVE: We conducted a post-hoc analysis of early inhaled nitric oxide (iNO)-randomized controlled trial data to identify associations pertinent to the management of moderate hypoxic respiratory failure in term/late preterm infants.

STUDY DESIGN: Univariate and multivariate logistic regression analyses were used to determine risk factors for the progression of respiratory failure and extracorporeal membrane oxygenation (ECMO)/death.

RESULT: Among the 299 enrolled infants, oxygenation index (OI) <20 at enrollment (odds ratio 0.52, confidence interval (CI) 0.27 to 0.97) and surfactant use before randomization (odds ratio 0.47, CI 0.24 to 0.91) were associated with decreased ECMO/death rates. Early surfactant use for respiratory distress syndrome, perinatal aspiration syndrome and pneumonia/sepsis was associated with lower risk of ECMO/death (P<0.001). Early iNO (OI 15 to 25) decreased the progression of respiratory failure to OI >30 (P=0.002) and to composite outcome of OI >30 or ECMO/death (P=0.02).

CONCLUSION: This post-hoc analysis suggests that early use of surfactant and iNO in moderate respiratory failure is associated with improved outcomes.

Author List

Konduri GG, Sokol GM, Van Meurs KP, Singer J, Ambalavanan N, Lee T, Solimano A

Author

Girija Ganesh Konduri MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Administration, Inhalation
Combined Modality Therapy
Drug Synergism
Extracorporeal Membrane Oxygenation
Female
Humans
Hypoxia
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Logistic Models
Male
Nitric Oxide
Oxygen
Pneumonia
Pulmonary Surfactants
Respiratory Distress Syndrome, Newborn
Risk Factors