Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants

Erika Fernandez, Kristi L. Watterberg, Roger G. Faix, Bradley A. Yoder, Michele C. Walsh, Conra Backstrom Lacy, Karen A. Osborne, Abhik Das, Douglas E. Kendrick, Barbara J. Stoll, Brenda B. Poindexter, Abbot R. Laptook, Kathleen A. Kennedy, Kurt Schibler, Edward F. Bell, Krisa P. Van Meurs, Ivan D. Frantz, Ronald N. Goldberg, Seetha Shankaran, Waldemar A. Carlo & 3 others Richard A. Ehrenkranz, Pablo J. Sánchez, Rosemary D. Higgins

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

Original languageEnglish (US)
Pages (from-to)1024-1030
Number of pages7
JournalAmerican Journal of Perinatology
Volume32
Issue number11
DOIs
StatePublished - Jan 2 2015

Fingerprint

Critical Illness
Neonatal Intensive Care Units
Newborn Infant
Blood Pressure
Premature Infants
Cohort Studies
Prospective Studies
Pregnancy
Incidence
Therapeutics
Research

Keywords

  • blood pressure
  • cardiovascular insufficiency
  • infant
  • newborn
  • outcomes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Fernandez, E., Watterberg, K. L., Faix, R. G., Yoder, B. A., Walsh, M. C., Lacy, C. B., ... Higgins, R. D. (2015). Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants. American Journal of Perinatology, 32(11), 1024-1030. https://doi.org/10.1055/s-0035-1547321

Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants. / Fernandez, Erika; Watterberg, Kristi L.; Faix, Roger G.; Yoder, Bradley A.; Walsh, Michele C.; Lacy, Conra Backstrom; Osborne, Karen A.; Das, Abhik; Kendrick, Douglas E.; Stoll, Barbara J.; Poindexter, Brenda B.; Laptook, Abbot R.; Kennedy, Kathleen A.; Schibler, Kurt; Bell, Edward F.; Van Meurs, Krisa P.; Frantz, Ivan D.; Goldberg, Ronald N.; Shankaran, Seetha; Carlo, Waldemar A.; Ehrenkranz, Richard A.; Sánchez, Pablo J.; Higgins, Rosemary D.

In: American Journal of Perinatology, Vol. 32, No. 11, 02.01.2015, p. 1024-1030.

Research output: Contribution to journalArticle

Fernandez, E, Watterberg, KL, Faix, RG, Yoder, BA, Walsh, MC, Lacy, CB, Osborne, KA, Das, A, Kendrick, DE, Stoll, BJ, Poindexter, BB, Laptook, AR, Kennedy, KA, Schibler, K, Bell, EF, Van Meurs, KP, Frantz, ID, Goldberg, RN, Shankaran, S, Carlo, WA, Ehrenkranz, RA, Sánchez, PJ & Higgins, RD 2015, 'Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants', American Journal of Perinatology, vol. 32, no. 11, pp. 1024-1030. https://doi.org/10.1055/s-0035-1547321
Fernandez, Erika ; Watterberg, Kristi L. ; Faix, Roger G. ; Yoder, Bradley A. ; Walsh, Michele C. ; Lacy, Conra Backstrom ; Osborne, Karen A. ; Das, Abhik ; Kendrick, Douglas E. ; Stoll, Barbara J. ; Poindexter, Brenda B. ; Laptook, Abbot R. ; Kennedy, Kathleen A. ; Schibler, Kurt ; Bell, Edward F. ; Van Meurs, Krisa P. ; Frantz, Ivan D. ; Goldberg, Ronald N. ; Shankaran, Seetha ; Carlo, Waldemar A. ; Ehrenkranz, Richard A. ; Sánchez, Pablo J. ; Higgins, Rosemary D. / Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants. In: American Journal of Perinatology. 2015 ; Vol. 32, No. 11. pp. 1024-1030.
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AU - Faix, Roger G.

AU - Yoder, Bradley A.

AU - Walsh, Michele C.

AU - Lacy, Conra Backstrom

AU - Osborne, Karen A.

AU - Das, Abhik

AU - Kendrick, Douglas E.

AU - Stoll, Barbara J.

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AU - Frantz, Ivan D.

AU - Goldberg, Ronald N.

AU - Shankaran, Seetha

AU - Carlo, Waldemar A.

AU - Ehrenkranz, Richard A.

AU - Sánchez, Pablo J.

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N2 - Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

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