Groves Alan M, Bennett Monica M, Loyd John, Clark Reese H, Tolia Veeral N
Pediatrix Neonatology of Texas, Austin, TX; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX.
Baylor Scott & White Research Institute, Dallas, TX.
J Pediatr. 2025 Feb;277:114414. doi: 10.1016/j.jpeds.2024.114414. Epub 2024 Nov 20.
To describe the trends in percentage oxygen requirement and mode of respiratory support delivered to extremely premature infants in the 12 weeks after birth.
This is a retrospective study of extremely premature infants (≤27 weeks) discharged from neonatal intensive care units managed by Pediatrix Medical Group between January 1, 2016, and December 31, 2021. Demographic and daily clinical data (mode of respiratory support and fraction of inspired oxygen [FiO]) were extracted from the Pediatrix Clinical Data Warehouse.
A total of 16 386 infants with a median gestational age of 25 weeks and birthweight of 765 g were included. There were 3808 (23.2%) infants who died. Of the cohort, 6019 (43.1%) infants who survived to 36 weeks' gestation had bronchopulmonary dysplasia. Median FiO at all gestations followed a biphasic pattern with a peak on day of life 1, reduction to a nadir by day 4 to 5, and an increase to a second peak around day 14. Infants born at lower gestational ages had a higher median FiO at each time point. At lower gestations, there were higher proportions of infants receiving mechanical ventilation and a later introduction of noninvasive modes.
Extremely premature infants show a consistent biphasic pattern in percentage of supplemental oxygen required after birth.
描述出生后12周内极早产儿的吸氧需求百分比及呼吸支持模式的变化趋势。
这是一项对2016年1月1日至2021年12月31日期间由Pediatrix医疗集团管理的新生儿重症监护病房出院的极早产儿（≤27周）进行的回顾性研究。人口统计学和每日临床数据（呼吸支持模式和吸入氧分数[FiO]）从Pediatrix临床数据仓库中提取。
共纳入16386例婴儿，中位胎龄为25周，出生体重为765g。有3808例（23.2%）婴儿死亡。在该队列中，6019例（43.1%）存活至孕36周的婴儿患有支气管肺发育不良。所有孕周的中位FiO呈双相模式，在出生第1天达到峰值，在第4至5天降至最低点，并在第14天左右升至第二个峰值。胎龄较低的婴儿在每个时间点的中位FiO较高。在较低孕周时，接受机械通气的婴儿比例较高，且无创模式的引入较晚。
极早产儿出生后所需补充氧气的百分比呈现一致的双相模式。
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