Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial. Study design Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5 minutes) were documented in 1054 infants of 24 0/7 -27 6/7 weeks of gestation while receiving supplemental oxygen during the first 3 days of life. Results Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA. Conclusion Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival. Trial registration ClinicalTrials.gov: NCT00233324.

Original languageEnglish (US)
Pages (from-to)49-56.e1
JournalJournal of Pediatrics
Volume186
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

Fingerprint

Surface-Active Agents
Oxygen
Pressure
Mortality
Growth
Gestational Age
Small for Gestational Age Infant
Extremely Premature Infants
Incidence
Pregnancy
Hypoxia

Keywords

  • hypoxia
  • intermittent hypoxemia
  • oxygen saturation
  • small for gestational age
  • supplemental oxygen

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network (2017). Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort. Journal of Pediatrics, 186, 49-56.e1. https://doi.org/10.1016/j.jpeds.2017.01.057

Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort. / SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network.

In: Journal of Pediatrics, Vol. 186, 01.07.2017, p. 49-56.e1.

Research output: Contribution to journalArticle

SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network 2017, 'Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort', Journal of Pediatrics, vol. 186, pp. 49-56.e1. https://doi.org/10.1016/j.jpeds.2017.01.057
SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network. Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort. Journal of Pediatrics. 2017 Jul 1;186:49-56.e1. https://doi.org/10.1016/j.jpeds.2017.01.057
SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network. / Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort. In: Journal of Pediatrics. 2017 ; Vol. 186. pp. 49-56.e1.
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T1 - Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

AU - SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Neonatal Research Network

AU - Di Fiore, Juliann M.

AU - Martin, Richard J.

AU - Li, Hong

AU - Morris, Nathan

AU - Carlo, Waldemar A.

AU - Finer, Neil

AU - Walsh, Michele

AU - Jobe, Alan H.

AU - Caplan, Michael S.

AU - Polin, Richard A.

AU - Laptook, Abbot R.

AU - Oh, William

AU - Hensman, Angelita M.

AU - Gingras, Dan

AU - Barnett, Susan

AU - Lillie, Sarah

AU - Francis, Kim

AU - Andrews, Dawn

AU - Angela, Kristen

AU - Fanaroff, Avroy A.

AU - Newman, Nancy S.

AU - Siner, Bonnie S.

AU - Zadell, Arlene

AU - Schibler, Kurt

AU - Donovan, Edward F.

AU - Bridges, Kate

AU - Alexander, Barbara

AU - Grisby, Cathy

AU - Mersmann, Marcia Worley

AU - Mincey, Holly L.

AU - Hessling, Jody

AU - Goldberg, Ronald N.

AU - Cotten, C. Michael

AU - Wallace, David K.

AU - Freedman, Sharon F.

AU - Auten, Kathy J.

AU - Fisher, Kimberly A.

AU - Foy, Katherine A.

AU - Stoll, Barbara J.

AU - Piazza, Anthony J.

AU - Buchter, Susie

AU - Carlton, David P.

AU - Hutchinson, Amy K.

AU - Hale, Ellen C.

AU - Higgins, Rosemary D.

AU - Archer, Stephanie Wilson

AU - Poindexter, Brenda B.

AU - Lemons, James A.

AU - Hamer, Faithe

AU - Herron, Dianne E.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial. Study design Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5 minutes) were documented in 1054 infants of 24 0/7 -27 6/7 weeks of gestation while receiving supplemental oxygen during the first 3 days of life. Results Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA. Conclusion Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival. Trial registration ClinicalTrials.gov: NCT00233324.

AB - Objective To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in infants born appropriate vs SGA enrolled in the Surfactant Positive Pressure and Oxygen Trial. Study design Median oxygen saturation and intermittent hypoxemia events (<80%, 20 seconds-5 minutes) were documented in 1054 infants of 24 0/7 -27 6/7 weeks of gestation while receiving supplemental oxygen during the first 3 days of life. Results Lower target infants who were small for gestational age had the lowest oxygen saturation and highest incidence of intermittent hypoxemia during the first 3 days of life. The lowest quartile of oxygen saturation (≤92%) during the first 3 days of life was associated with lower 90-day survival for both infants born appropriate and SGA. An increased incidence of intermittent hypoxemia events during the first 3 days of life was associated with lower 90-day survival only in infants born SGA. Conclusion Lower achieved oxygen saturation during the first 3 days of life was associated with lower 90-day survival in extremely preterm infants. Infants born SGA had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased intermittent hypoxemia events and lower survival. Trial registration ClinicalTrials.gov: NCT00233324.

KW - hypoxia

KW - intermittent hypoxemia

KW - oxygen saturation

KW - small for gestational age

KW - supplemental oxygen

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