Does aggressive phototherapy increase mortality while decreasing profound impairment among the smallest and sickest newborns?
| Autor: | Cathy Grisby, Claudia Pedroza, Jon E. Tyson, Charles Green, William Oh, Rosemary D. Higgins, David K. Stevenson, K. P. Van Meurs, Dale L. Phelps, Michael O'Shea, Georgia E. McDavid, B. Morris, John Langer |
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| Rok vydání: | 2012 |
| Předmět: |
impairment
Pediatrics medicine.medical_specialty Bayesian analysis MEDLINE Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial statistical interaction law 030225 pediatrics Severity of illness medicine severity of illness 030212 general & internal medicine ELBW infant Extramural business.industry Obstetrics and Gynecology Phototherapy randomized clinical trial Infant newborn 3. Good health Pediatrics Perinatology and Child Health bilirubin business |
| Zdroj: | Journal of perinatology : official journal of the California Perinatal Association |
| ISSN: | 1476-5543 0743-8346 |
| DOI: | 10.1038/jp.2012.64 |
| Popis: | Objective Aggressive phototherapy (AgPT) is widely used and assumed to be safe and effective for even the most immature infants. We assessed whether the benefits and hazards for the smallest and sickest infants differed from those for other extremely low birth weight (ELBW; (≤1000 g) infants in our Neonatal Research Network trial, the only large trial of AgPT. Study Design ELBW infants (n=1974) were randomized to AgPT or conservative phototherapy at age 12–36 hours. The effect of AgPT on outcomes (death; impairment; profound impairment; death or impairment [primary outcome], and death or profound impairment) at 18–22 months corrected age was related to BW stratum (501–750 g; 751–1000 g) and baseline severity of illness using multilevel regression equations. The probability of benefit and of harm was directly assessed with Bayesian analyses. Results Baseline illness severity was well characterized using mechanical ventilation and FiO2 at 24 hours age. Among mechanically ventilated infants ≤750 g BW (n =684), a reduction in impairment and in profound impairment was offset by higher mortality (p for interaction |
| Databáze: | OpenAIRE |
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