Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants

Erika Fernandez; Kristi L. Watterberg; Roger G. Faix; Bradley A. Yoder; Michele C. Walsh; Conra Backstrom Lacy; Karen A. Osborne; Abhik Das; Douglas E. Kendrick; Barbara J. Stoll; Brenda B. Poindexter; Abbot R. Laptook; Kathleen A. Kennedy; Kurt Schibler; Edward F. Bell; Krisa P. Van Meurs; Ivan D. Frantz; Ronald N. Goldberg; Seetha Shankaran; Waldemar A. Carlo; Richard A. Ehrenkranz; Pablo J. Sánchez; Rosemary D. Higgins

doi:10.1055/s-0035-1547321

Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants

Erika Fernandez, Kristi L. Watterberg, Roger G. Faix, Bradley A. Yoder, Michele C. Walsh, Conra Backstrom Lacy, Karen A. Osborne, Abhik Das, Douglas E. Kendrick, Barbara J. Stoll, Brenda B. Poindexter, Abbot R. Laptook, Kathleen A. Kennedy, Kurt Schibler, Edward F. Bell, Krisa P. Van Meurs, Ivan D. Frantz, Ronald N. Goldberg, Seetha Shankaran, Waldemar A. CarloRichard A. Ehrenkranz, Pablo J. Sánchez, Rosemary D. Higgins

Pediatrics

Research output: Contribution to journal › Review article › peer-review

1 Scopus citations

Abstract

Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O₂. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

Original language	English (US)
Pages (from-to)	1024-1030
Number of pages	7
Journal	American Journal of Perinatology
Volume	32
Issue number	11
DOIs	https://doi.org/10.1055/s-0035-1547321
State	Published - Mar 31 2015

Keywords

blood pressure
cardiovascular insufficiency
infant
newborn
outcomes

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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10.1055/s-0035-1547321

Cite this

Fernandez, E., Watterberg, K. L., Faix, R. G., Yoder, B. A., Walsh, M. C., Lacy, C. B., Osborne, K. A., Das, A., Kendrick, D. E., Stoll, B. J., Poindexter, B. B., Laptook, A. R., Kennedy, K. A., Schibler, K., Bell, E. F., Van Meurs, K. P., Frantz, I. D., Goldberg, R. N., Shankaran, S., ... Higgins, R. D. (2015). Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants. American Journal of Perinatology, 32(11), 1024-1030. https://doi.org/10.1055/s-0035-1547321

Fernandez, E, Watterberg, KL, Faix, RG, Yoder, BA, Walsh, MC, Lacy, CB, Osborne, KA, Das, A, Kendrick, DE, Stoll, BJ, Poindexter, BB, Laptook, AR, Kennedy, KA, Schibler, K, Bell, EF, Van Meurs, KP, Frantz, ID, Goldberg, RN, Shankaran, S, Carlo, WA, Ehrenkranz, RA, Sánchez, PJ & Higgins, RD 2015, 'Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants', American Journal of Perinatology, vol. 32, no. 11, pp. 1024-1030. https://doi.org/10.1055/s-0035-1547321

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title = "Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants",

abstract = "Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.",

keywords = "blood pressure, cardiovascular insufficiency, infant, newborn, outcomes",

author = "Erika Fernandez and Watterberg, {Kristi L.} and Faix, {Roger G.} and Yoder, {Bradley A.} and Walsh, {Michele C.} and Lacy, {Conra Backstrom} and Osborne, {Karen A.} and Abhik Das and Kendrick, {Douglas E.} and Stoll, {Barbara J.} and Poindexter, {Brenda B.} and Laptook, {Abbot R.} and Kennedy, {Kathleen A.} and Kurt Schibler and Bell, {Edward F.} and {Van Meurs}, {Krisa P.} and Frantz, {Ivan D.} and Goldberg, {Ronald N.} and Seetha Shankaran and Carlo, {Waldemar A.} and Ehrenkranz, {Richard A.} and S{\'a}nchez, {Pablo J.} and Higgins, {Rosemary D.}",

note = "Publisher Copyright: {\textcopyright} 2015 by Thieme Medical ublishers, Inc., 333 Seventh Avenue, ew York, NY 10001, USA.",

year = "2015",

month = mar,

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doi = "10.1055/s-0035-1547321",

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T1 - Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants

AU - Fernandez, Erika

AU - Watterberg, Kristi L.

AU - Faix, Roger G.

AU - Yoder, Bradley A.

AU - Walsh, Michele C.

AU - Lacy, Conra Backstrom

AU - Osborne, Karen A.

AU - Das, Abhik

AU - Kendrick, Douglas E.

AU - Stoll, Barbara J.

AU - Poindexter, Brenda B.

AU - Laptook, Abbot R.

AU - Kennedy, Kathleen A.

AU - Schibler, Kurt

AU - Bell, Edward F.

AU - Van Meurs, Krisa P.

AU - Frantz, Ivan D.

AU - Goldberg, Ronald N.

AU - Shankaran, Seetha

AU - Carlo, Waldemar A.

AU - Ehrenkranz, Richard A.

AU - Sánchez, Pablo J.

AU - Higgins, Rosemary D.

PY - 2015/3/31

Y1 - 2015/3/31

N2 - Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

AB - Background We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants. Objective This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death. Study Design The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed. Results All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death. Conclusions The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.

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KW - cardiovascular insufficiency

KW - infant

KW - newborn

KW - outcomes

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JO - American Journal of Perinatology

JF - American Journal of Perinatology

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Definitions of Cardiovascular Insufficiency and Relation to Outcomes in Critically Ill Newborn Infants

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