In:
American Journal of Perinatology, Georg Thieme Verlag KG
Abstract:
Objective The aim of the study is to determine clinical correlates of moderate to severe bronchopulmonary dysplasia (BPD) in preterm infants following surgical necrotizing enterocolitis (NEC). Study Design This is a retrospective, single-center cohort study comparing patients with moderate to severe BPD to patients with non/mild BPD among surgical NEC infants. BPD was defined by NIH 2001 consensus definition. Results Of 92 consecutive neonates with surgical NEC, 77% (71/92) had moderate/severe BPD and 22% (21/92) had non/mild BPD. The patent ductus arteriosus (PDA) was significantly higher in those developing moderate/severe BPD (67.6% [48/71]) than non/mild BPD (28.6% [6/21] ; p = 0.001). Postoperatively, infants with moderate/severe BPD had more severe acute kidney injury (AKI; 67.6 [48/71] vs. 28.6% [6/21] ; p = 0.001), were intubated longer (40.5 [interquartile (IQR): 12, 59] vs. 6 days [IQR: 2, 13] ; p 〈 0.001), received more parenteral nutrition (109 [IQR: 77, 147] vs. 55 days [IQR: 19, 70] ; p 〈 0.001), developed higher surgical morbidity (46.5 [33/71] vs. 14.3% [3/21] ; p = 0.008), had more intestinal failure (62.5 vs. 13.3%; p 〈 0.001), required a longer hospital stay (161 [IQR: 112, 186] vs. 64 days [IQR: 20, 91] ; p 〈 0.001), and were more likely to need home oxygen. In a multivariable analysis, lower birth weight (OR = 0.3, [95% confidence interval (CI): 0.1–0.5]; p = 0.001), PDA (OR = 10.3, [95% CI: 1.6–65.4] ; p = 0.014), and longer parenteral nutritional days (OR = 8.8; [95% CI: 2.0–43.0]; p = 0.005) were significantly and independently associated with higher odds of moderate/severe versus non-/mild BPD. Conclusion Development of moderate/severe BPD occurred in the majority of preterm infants with surgical NEC in this consecutive series. Preterm infants with moderate/severe BPD were more likely to have a PDA before NEC. Development of moderate/severe BPD was associated with significantly greater burden and duration of postoperative morbidity following surgical NEC. Identifying surgical NEC infants at increased risk of moderate/severe BPD and developing lung protection strategies may improve surgical NEC outcomes. Key Points
Type of Medium:
Online Resource
ISSN:
0735-1631
,
1098-8785
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2022
detail.hit.zdb_id:
2042426-7
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