Prolonged requirements for mechanical ventilation and tube feeding support predicted 18-month outcomes for neonatal encephalopathy
Prolonged requirements for mechanical ventilation and tube feeding support predicted 18-month outcomes for neonatal encephalopathy
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机械通气和管饲支持的长期需求预测新生儿脑病的 18 个月结果
DOI：
10.1111/apa.16687
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Iwata O; Baby Cooling Registry of Japan.
中科院分区：
文献类型：
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作者：
Tsuda K;Shibasaki J;Takeuchi A;Mukai T;Sugiyama Y;Isayama T;Ioroi T;Takahashi A;Yutaka N;Iwata O; Baby Cooling Registry of Japan.
目的：我们评估了低温治疗的低氧缺血性脑病婴儿延长机械通气或管饲支持需求对18个月综合预后的预测能力。方法：这项回顾性、全国性、观察性研究的重点是2012年1月1日至2016年12月31日在日本婴儿冷却登记处登记的新生儿。不良结局定义为死亡或生存，伴有脑瘫、视觉或听觉障碍，或在18月龄时需要机械通气或管饲。结果在最后的队列中，591名儿童中有165名（28%）发生了不良结局。这些是通过延长机械通气或管饲的依赖时间超过7天和14天来预测的。阳性预测值分别为0.34 （95% CI 0.33 ~ 0.34）和0.60 (95% CI 0.56 ~ 0.62)，阴性预测值分别为0.97 （95% CI 0.91 ~ 0.99）和0.93 (95% CI 0.90 ~ 0.95)，曲线下面积分别为0.59 （95% CI 0.54 ~ 0.64）和0.81 （95% CI 0.77 ~ 0.85）。结论：对机械通气或管饲的长期依赖超过14天可能有助于预测接受治疗性低温治疗的新生儿18个月的预后。
AimWe evaluated the predictive ability of prolonged requirements for mechanical ventilation or tube feeding support for 18‐month composite outcomes in infants with hypoxic‐ischaemic encephalopathy treated with hypothermia.MethodsThis retrospective, nationwide, observational study focused on newborn infants registered in Japan's Baby Cooling Registry between 1 January 2012 and 31 December 2016. The adverse outcomes were defined as death or survival with cerebral palsy, visual or auditory impairment or the requirement for mechanical ventilation or tube feeding at 18 months of age.ResultsAdverse outcomes occurred in 165 (28%) of the 591 children in the final cohort. These were predicted by prolonged dependence on mechanical ventilation or tube feeding for more than seven and more than 14 days. The respective values were positive predictive value 0.34 (95% CI 0.33–0.34) and 0.60 (95% CI 0.56–0.62), negative predictive value 0.97 (95% CI 0.91–0.99) and 0.93 (95% CI 0.90–0.95) and area under the curve 0.59 (95% CI 0.54–0.64) and 0.81 (95% CI 0.77–0.85).ConclusionProlonged dependence on mechanical ventilation or tube feeding for more than 14 days may be useful in predicting 18‐month outcomes in newborn infants who have received therapeutic hypothermia.