Early Cumulative Supplemental Oxygen Predicts Bronchopulmonary Dysplasia in High Risk Extremely Low Gestational Age Newborns.
Early Cumulative Supplemental Oxygen Predicts Bronchopulmonary Dysplasia in High Risk Extremely Low Gestational Age Newborns.
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DOI：
10.1016/j.jpeds.2016.06.079
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发表时间：
2016-10
影响因子：
5.1
通讯作者：
Keller, Roberta L.
中科院分区：
文献类型：
--
作者：
Wai, Katherine C.;Kohn, Michael A.;Ballard, Roberta A.;Truog, William E.;Black, Dennis M.;Asselin, Jeanette M.;Ballard, Philip L.;Rogers, Elizabeth E.;Keller, Roberta L.
为了评估早期累积补充氧（CSO）暴露用于预测BPD或死亡的预后准确性，并评估CSO与BPD或死亡的独立关联，我们对晚期表面活性剂试验进行了二次分析，该试验招募了511名≤28周孕龄的婴儿，他们在7-14天进行机械通气。我们的主要结局是经后36周BPD或死亡，由生理性氧/流量挑战决定。计算平均每日补充氧（FiO2−0.21）。CSO的计算方法是计算到28日龄期间平均每日补充氧的总和。我们生成受试者工作曲线下面积（AUROC）来评估CSO预测BPD或死亡的准确性。我们在多变量模型中评估CSO与BPD或死亡之间的独立关系，同时调整平均气道压力。婴儿出生时25.2±1.2周，700±165克。在第14天，CSO的AUROC（0.70, 0.65-0.74）显著优于CSO在早期时间点的预后预测；它没有随着后来数据的增加而增加。在多变量模型中，14天时CSO增加1会增加BPD或死亡的几率（or =1.7, 1.3-2.2; p<0.0001），相当于每日补充氧量增加7%。在高风险ELGAN中，CSO的预测准确性在14天达到峰值。CSO与BPD或死亡独立相关。这一指数可以确定哪些婴儿可以从早期干预中受益，以预防BPD。
To assess the prognostic accuracy of early cumulative supplemental oxygen (CSO) exposure for prediction of BPD or death and to evaluate the independent association of CSO with BPD or death We performed a secondary analysis of the Trial of Late Surfactant, which enrolled 511 infants ≤28 weeks' gestational age who were mechanically ventilated at 7–14 days. Our primary outcome was BPD or death at 36 weeks' post-menstrual age, determined by physiologic oxygen/flow challenge. Average daily supplemental oxygen (FiO2−0.21) was calculated. CSO was calculated as the sum of the average daily supplemental oxygen over time periods of interest up to 28 days of age. We generated area under the receiver-operating-curve (AUROC) to evaluate the accuracy of CSO for prediction of BPD or death. We assessed the independent relationship between CSO and BPD or death in multivariate modeling, while adjusting for mean airway pressure. Infants were 25.2±1.2 weeks and 700±165g at birth. At 14 days, AUROC for CSO (0.70, 0.65–0.74) was significantly better than CSO at earlier time points for outcome prediction; it did not increase with addition of later data. In multivariate modeling, an increase of 1 in CSO at 14 days increased the odds of BPD or death (OR=1.7, 1.3–2.2; p<0.0001), which corresponds to a 7% higher daily supplemental oxygen. In high-risk ELGAN, the predictive accuracy of CSO plateaus at 14 days. CSO is independently associated with BPD or Death. This index may identify infants who could benefit from early intervention to prevent BPD.
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DOI：
10.1164/rccm.201412-2142pp
发表时间：
2015-07-15
影响因子：
24.7
作者：
Islam, Jessica Y.;Keller, Roberta L.;Moore, Paul E.
通讯作者：
Moore, Paul E.
影响因子：
158.5
作者：
Ballard, Roberta A.;Truog, William E.;Coburn, Christine E.
通讯作者：
Coburn, Christine E.
DOI：
10.1002/bdra.23220
发表时间：
2014-03-01
影响因子：
--
作者：
Bhandari, Vineet
通讯作者：
Bhandari, Vineet
影响因子：
3.6
作者：
Ahola, T;Fellman, V;Lapatto, R
通讯作者：
Lapatto, R
影响因子：
2.4
作者：
Hislop, AA
通讯作者：
Hislop, AA