Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia.

Abstract:

BACKGROUND:Bradycardia and oxygen desaturation episodes are common among preterm very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU), and their association with adverse outcomes such as bronchopulmonary dysplasia (BPD) is unclear. METHODS:For 502 VLBW infants we quantified bradycardias (HR < 100 for ≥ 4 s) and desaturations (SpO2 < 80% for ≥ 10 s), combined bradycardia and desaturation (BD) events, and percent time in events in the first 4 weeks after birth (32 infant-years of data). We tested logistic regression models of clinical risks (including a respiratory acuity score incorporating FiO2 and level of respiratory support) to estimate the risks of BPD or death and secondary outcomes. We then tested the additive value of the bradycardia and desaturation metrics for outcomes prediction. RESULTS:BPD occurred in 187 infants (37%). The clinical risk model had ROC area for BPD of 0.874. Measures of desaturation, but not bradycardia, significantly added to the predictive model. Desaturation metrics also added to clinical risks for prediction of severe intraventricular hemorrhage, retinopathy of prematurity and prolonged length of stay in the NICU. CONCLUSIONS:Oxygen desaturations in the first month of the NICU course are associated with risk of BPD and other morbidities in VLBW infants.

journal_name

Pediatr Res

journal_title

Pediatric research

authors

Fairchild KD,Nagraj VP,Sullivan BA,Moorman JR,Lake DE

doi

10.1038/s41390-018-0223-5

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

987-993

issue

7

eissn

0031-3998

issn

1530-0447

pii

10.1038/s41390-018-0223-5

journal_volume

85

pub_type

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