Incidence, management, and outcomes of cardiovascular insufficiency in critically ill term and late preterm newborn infants

Erika Fernandez, Kristi L. Watterberg, Roger G. Faix, Bradley A. Yoder, Michele C. Walsh, Conra B ackstrom 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. CarloRichard A. Ehrenkranz, Pablo J. Sanchez, Rosemary D. Higgins

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE: The objective of this study was to characterize the incidence, management, and short-term outcomes of cardiovascular insufficiency (CVI) in mechanically ventilated newborns, evaluating four separate prespecified definitions.

STUDY DESIGN: Multicenter, prospective cohort study of infants ≥34 weeks gestational age (GA) and on mechanical ventilation during the first 72 hours. CVI was prospectively defined as either (1) mean arterial pressure (MAP) 

RESULTS: Of 647 who met inclusion criteria, 419 (65%) met ≥1 definition of CVI. Of these, 98% received fluid boluses, 36% inotropes, and 17% corticosteroids. Of treated infants, 46% did not have CVI as defined by a MAP 

CONCLUSION: More than half of the infants met at least one definition of CVI. However, almost half of the treated infants met none of the definitions. Inotropic therapy was associated with increased mortality. These findings can help guide the design of future studies of CVI in newborns.

Original languageEnglish (US)
Pages (from-to)947-956
Number of pages10
JournalAmerican Journal of Perinatology
Volume31
Issue number11
DOIs
StatePublished - Nov 1 2014

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fernandez, E., Watterberg, K. L., Faix, R. G., Yoder, B. A., Walsh, M. C., Lacy, C. B. A., Osborne, K. A., Das, A., Kendrick, D. E., Stoll, B. J., Poindexter, B. B., Laptook, A. R., Kennedy, K. A., Schibler, K., Bell, E. F., Van Meurs, K. P., Frantz, I. D., Goldberg, R. N., Shankaran, S., ... Higgins, R. D. (2014). Incidence, management, and outcomes of cardiovascular insufficiency in critically ill term and late preterm newborn infants. American Journal of Perinatology, 31(11), 947-956. https://doi.org/10.1055/s-0034-1368089