Reduced oxygen concentration for the resuscitation of infants with congenital diaphragmatic hernia.

Autor: Riley JS; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Antiel RM; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Rintoul NE; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Ades AM; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Waqar LN; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Lin N; Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Herkert LM; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., D'Agostino JA; Neonatal Follow-up Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Hoffman C; Neonatal Follow-up Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Peranteau WH; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Flake AW; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Adzick NS; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Hedrick HL; The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Hedrick@email.chop.edu.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2018 Jul; Vol. 38 (7), pp. 834-843. Date of Electronic Publication: 2018 Jun 11.
DOI: 10.1038/s41372-017-0031-5
Abstrakt: Objective: To evaluate whether infants with congenital diaphragmatic hernia (CDH) can be safely resuscitated with a reduced starting fraction of inspired oxygen (FiO 2 ) of 0.5.
Study Design: A retrospective cohort study comparing 68 patients resuscitated with starting FiO 2 0.5 to 45 historical controls resuscitated with starting FiO 2 1.0.
Results: Reduced starting FiO 2 had no adverse effect upon survival, duration of intubation, need for ECMO, duration of ECMO, or time to surgery. Furthermore, it produced no increase in complications, adverse neurological events, or neurodevelopmental delay. The need to subsequently increase FiO 2 to 1.0 was associated with female sex, lower gestational age, liver up, lower lung volume-head circumference ratio, decreased survival, a higher incidence of ECMO, longer time to surgery, periventricular leukomalacia, and lower neurodevelopmental motor scores.
Conclusion: Starting FiO 2 0.5 may be safe for the resuscitation of CDH infants. The need to increase FiO 2 to 1.0 during resuscitation is associated with worse outcomes.
Databáze: MEDLINE
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