Survival and Neurodevelopmental Outcomes of Preterms Resuscitated With Different Oxygen Fractions

Fecha de publicación: 01/12/2016

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

Rook, D
Iriondo, M
Izquierdo, M
van Goudoever, H

Grupos

Perinatología

Leader

Máximo Vento Torres

Abstract

BACKGROUND AND OBJECTIVES: Stabilization of preterm infants after birth frequently requires oxygen supplementation. At present the optimal initial oxygen inspiratory fraction (FiO(2)) for preterm stabilization after birth is still under debate. We aimed to compare neurodevelopmental outcomes of extremely preterm infants at 24 months corrected age randomly assigned to be stabilized after birth with an initial FiO(2) of 0.3 versus 0.6 to 0.65 in 3 academic centers from Spain and the Netherlands. METHODS: Randomized, controlled, double-blinded, multicenter, international clinical trial enrolling preterm infants <32 weeks' gestation assigned to an initial FiO(2) of 0.3 (Lowox group) or 0.6 to 0.65 (Hiox group). During stabilization, arterial pulse oxygen saturation and heart rate were continuously monitored and FiO(2) was individually titrated to keep infants within recommended ranges. At 24 months, blinded researchers used the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) to assess visual acuity, neurosensory deafness, and language skills. RESULTS: A total of 253 infants were recruited and 206 (81.4%) completed follow-up. No differences in perinatal characteristics, oxidative stress, or morbidities during the neonatal period were assessed. Mortality at hospital discharge or when follow-up was completed didn't show differences between the groups. No differences regarding Bayley-III scale scores (motor, cognitive, and language composites), neurosensorial handicaps, cerebral palsy, or language skills between groups were found. CONCLUSIONS: The use of an initial lower (0.3) or higher (0.6-0.65) FiO(2) during stabilization of extremely preterm infants in the delivery room does not influence survival or neurodevelopmental outcomes at 24 months.

Datos de la publicación

ISSN/ISSNe:: 0031-4005, 1098-4275
Tipo:: Article
Páginas:: -
DOI:: 10.1542/peds.2016-1405
Factor de Impacto:: 3,511 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Boronat, N:: Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain
Aguar, M:: Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain
Rook, D:: Sophia Childrens Univ Hosp, Erasmus Med Ctr, Div Neonatol, Rotterdam, Netherlands
Iriondo, M:: Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain

Hosp St Joan Deu, Div Neonatol, Barcelona, Spain
Cernada, M:: Instituto de Investigación. Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain
Nunez, A:: Instituto de Investigación. Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain
Izquierdo, M:: Hosp St Joan Deu, Div Neonatol, Barcelona, Spain
Cubells, E:: Instituto de Investigación. Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain
Martinez, M:: Instituto de Investigación. Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain
Parra, A:: Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain
van Goudoever, H:: Vrije Univ Amsterdam, Med Ctr, Acad Med Ctr Amsterdam, Dept Pediat,Emma Childrens Hosp, Amsterdam, Netherlands
Vento, M:: Univ & Polytech Hosp La Fe, Div Neonatol, Valencia, Spain

Instituto de Investigación. Hlth Res Inst La Fe, Neonatal Res Unit, Valencia, Spain

Keywords

EMERGENCY CARDIOVASCULAR CARE; LESS OXIDATIVE STRESS; 100-PERCENT OXYGEN; DELIVERY ROOM; CARDIOPULMONARY-RESUSCITATION; TREATMENT RECOMMENDATIONS; PERINATAL-CARE; INFANTS; CHILDREN; BORN