Extremely low birthweight neonates with protracted ventilation: Mortality and 18-month neurodevelopmental outcomes
Extremely low birthweight neonates with protracted ventilation: Mortality and 18-month neurodevelopmental outcomes
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DOI：
10.1016/j.jpeds.2005.01.047
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发表时间：
2005-06-01
影响因子：
5.1
通讯作者：
Fanaroff, AA
中科院分区：
文献类型：
--
作者：
Walsh, MC;Morris, BH;Fanaroff, AA
目的 比较极低出生体重（ELBW；501-1000 g）婴儿通气持续时间与死亡率和不良神经发育结局的关系。 研究设计 对 1995 年至 1998 年在国家儿童健康和人类发展研究所 (NICHD) 新生儿研究网络中心出生的 5364 名出生体重为 501-1000 g 的婴儿前瞻性收集的数据进行回顾性分析。机械通气和神经发育结果。结果 总生存率为 71%。幸存者的中位通气持续时间为 23 天； 75% 的患者在 39 天后不再使用机械通气，7% 的患者通气时间 >= 60 天。在通气时间 >= 60 天的患者中，24% 的人没有受到任何损伤而存活下来。在通气时间 >= 90 天的患者中，只有 7% 的人没有受到损害。在通气> = 120天的患者中，所有幸存者均受到损害。 结论 长期通气的ELBW预后仍然严峻。保持插管的人群生存率降低且损伤率高。随着通气时间的增加，应告知这些婴儿的父母预后的变化。
Objective To compare duration of ventilation to mortality and adverse neurodevelopmental outcomes among extremely low birth weight (ELBW; 501-1000 g) infants.Study design Retrospective analysis of prospectively collected data from 5364 infants with a birth weight of 501 to 1000 g born at National Institute of Child Health and Human Development (NICHD) Neonatal Research Network centers from 1995 to 1998. The main outcome measures were: survival, duration of mechanical ventilation, and neurodevelopmental-outcome.Results Overall survival was 71%. The median duration of ventilation for survivors was 23 days; 75% were free of mechanical ventilation by 39 days, and 7% were ventilated for >= 60 days. Of those ventilated for >= 60 days, 24% survived without impairment. Of those ventilated for >= 90 days, only 7% survived without impairment. Of those ventilated >= 120 days, all survivors were impaired.Conclusions The prognosis for ELBW with protracted ventilation remains grim. The cohort who remain intubated have diminished survival and high rates of impairment. Parents of these infants should be informed of changes in prognosis as the time of ventilation increases.