Outcomes of neonates born at <26 weeks gestational age who receive extensive cardiopulmonary resuscitation compared with airway and breathing support

on behalf of the Canadian Neonatal Network Investigators

doi:10.1038/s41372-019-0570-z

Outcomes of neonates born at <26 weeks gestational age who receive extensive cardiopulmonary resuscitation compared with airway and breathing support

on behalf of the Canadian Neonatal Network Investigators

Résultat de recherche: Article › examen par les pairs

7 Citations (Scopus)

Résumé

Objective: To evaluate outcomes of preterm infants <26 weeks gestational age (GA) following postdelivery extensive cardiopulmonary resuscitation (ECPR) compared with airway and breathing support (ABS). Study design: Retrospective review of Canadian Neonatal Network data during January 2010 to December 2016. The primary outcome was death or severe morbidity (intraventricular hemorrhage ≥grade 3 or periventricular leucomalacia, retinopathy of prematurity ≥stage 3, bronchopulmonary dysplasia, or necrotizing enterocolitis). Result: Among 3633 infants analyzed, 433 (11.9%) received ECPR. In multivariable analysis, death or severe morbidity was higher in the ECPR versus ABS group [adjusted odds ratio 2.26 (95% confidence interval 1.49, 3.43)]. The majority of the difference was due to increased mortality, which occurred mostly during the first week of life. Conclusion: These data from a recent cohort of infants near the limits of viability may be useful for prognostication for health care providers and counseling of parents.

Langue d'origine	English
Pages (de-à)	481-487
Nombre de pages	7
Journal	Journal of Perinatology
Volume	40
Numéro de publication	3
DOI	https://doi.org/10.1038/s41372-019-0570-z
Statut de publication	Published - mars 1 2020
Publié à l'externe	Oui

Note bibliographique

Funding Information:
Kanungo5, Joseph Ting6, Zenon Cieslak7, Rebecca Sherlock8, Ayman Abou Mehrem9, Jennifer Toye10, Carlos Fajardo11, Zarin Kalapesi12, and Jaya Bodani12, Koravangattu Sankaran13, and Sibasis Daspal13, Mary Seshia14, Ruben Alvaro15, Amit Mukerji16, Orlando Da Silva17, Chuks Nwaesei18, Kyong-Soon Lee19, Michael Dunn20, Brigitte Lemyre21, Faiza Khurshid22, Ermelinda Pelausa23, Keith Barrington24, and Anie Lapointe24, Christine Drolet25, and Bruno Piedboeuf25, Martine Claveau26, and Marc Beltempo26, Valerie Bertelle27, and Edith Masse27, Roderick Canning28, Hala Makary29, Cecil Ojah30, and Luis Monterrosa30, Julie Emberley31, Jehier Afifi32, Andrzej Kajetanowicz33 5Victoria General Hospital, Victoria, BC, Canada; 6Women’s Hospital and Health Centre, Vancouver, BC, Canada; 7Royal Columbian Hospital, New Westminster, BC, Canada; 8Surrey Memorial Hospital, Surrey, BC, Canada; 9Foothills Medical Centre, Calgary, AB, Canada; 10Royal Alexandra Hospital, Edmonton, AB, Canada; 11Alberta Children’s Hospital, Calgary, AB, Canada; 12Regina General Hospital, Regina, SK, Canada; 13Royal University Hospital, Saskatoon, SK, Canada; 14Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 15St. Boniface General Hospital, Winnipeg, MB, Canada; 16Hamilton Health Sciences Centre, Hamilton, ON, Canada; 17London Health Sciences Centre, London, ON, Canada; 18Windsor Regional Hospital, Windsor, ON, Canada; 19Hospital for Sick Children, Toronto, ON, Canada; 20Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 21Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 22Kingston General Hospital, Kingston, ON, Canada; 23Jewish General Hospital, Montréal, QC, Canada; 24Hôpital Sainte-Justine, Montréal, QC, Canada; 25Centre Hospitalier Universitaire de Québec, Sainte Foy, QC, Canada; 26Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada; 27Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 28Moncton Hospital, Moncton, NB, Canada; 29Dr. Everett Chalmers Hospital, Fredericton, NB, Canada;30Saint John Regional Hospital, Saint John, NB, Canada; 31Janeway Children’s Health and Rehabilitation Centre, St. John’s, NF, Canada; 32IWK Health Centre, Halifax, NS, Canada; 33Cape Breton Regional Hospital, Sydney, NS, Canada Author contributions VS conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. OE conceptualized and designed the study, and reviewed and revised the manuscript. PSS conceptualized and designed the study, Acknowledgements The authors gratefully acknowledge all site investigators and abstractors of the CNN. We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON, for organizational support of the CNN, CNFUN, and this project. In addition, we thank Sarah Hutchinson, PhD, and Iris Kulbatski, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals.

Funding Information:
Funding Although no specific funding has been received for this study, organizational support for the CNN was provided by the MiCare Research Centre at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a CIHR Team Grant (CTP 87518), the Ontario Ministry of Health and individual participating centers. Dr Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynaecology

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10.1038/s41372-019-0570-z

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@article{7651679a5f66432b8338ec838910d320,

title = "Outcomes of neonates born at <26 weeks gestational age who receive extensive cardiopulmonary resuscitation compared with airway and breathing support",

abstract = "Objective: To evaluate outcomes of preterm infants <26 weeks gestational age (GA) following postdelivery extensive cardiopulmonary resuscitation (ECPR) compared with airway and breathing support (ABS). Study design: Retrospective review of Canadian Neonatal Network data during January 2010 to December 2016. The primary outcome was death or severe morbidity (intraventricular hemorrhage ≥grade 3 or periventricular leucomalacia, retinopathy of prematurity ≥stage 3, bronchopulmonary dysplasia, or necrotizing enterocolitis). Result: Among 3633 infants analyzed, 433 (11.9%) received ECPR. In multivariable analysis, death or severe morbidity was higher in the ECPR versus ABS group [adjusted odds ratio 2.26 (95% confidence interval 1.49, 3.43)]. The majority of the difference was due to increased mortality, which occurred mostly during the first week of life. Conclusion: These data from a recent cohort of infants near the limits of viability may be useful for prognostication for health care providers and counseling of parents.",

author = "{on behalf of the Canadian Neonatal Network Investigators} and Vivek Shukla and Omar Elkhateeb and Shah, {Prakesh S.} and Junmin Yang and Lee, {Kyong Soon} and Jaideep Kanungo and Joseph Ting and Zenon Cieslak and Rebecca Sherlock and Ayman Abou Mehrem and Jennifer Toye and Carlos Fajardo and Zarin Kalapesi and Jaya Bodani and Koravangattu Sankaran and Sibasis Daspal and Mary Seshia and Ruben Alvaro and Amit Mukerji and {Da Silva}, Orlando and Chuks Nwaesei and Michael Dunn and Brigitte Lemyre and Faiza Khurshid and Ermelinda Pelausa and Keith Barrington and Anie Lapointe and Christine Drolet and Bruno Piedboeuf and Martine Claveau and Marc Beltempo and Valerie Bertelle and Edith Masse and Roderick Canning and Hala Makary and Cecil Ojah and Luis Monterrosa and Julie Emberley and Jehier Afifi and Andrzej Kajetanowicz",

note = "Funding Information: Kanungo5, Joseph Ting6, Zenon Cieslak7, Rebecca Sherlock8, Ayman Abou Mehrem9, Jennifer Toye10, Carlos Fajardo11, Zarin Kalapesi12, and Jaya Bodani12, Koravangattu Sankaran13, and Sibasis Daspal13, Mary Seshia14, Ruben Alvaro15, Amit Mukerji16, Orlando Da Silva17, Chuks Nwaesei18, Kyong-Soon Lee19, Michael Dunn20, Brigitte Lemyre21, Faiza Khurshid22, Ermelinda Pelausa23, Keith Barrington24, and Anie Lapointe24, Christine Drolet25, and Bruno Piedboeuf25, Martine Claveau26, and Marc Beltempo26, Valerie Bertelle27, and Edith Masse27, Roderick Canning28, Hala Makary29, Cecil Ojah30, and Luis Monterrosa30, Julie Emberley31, Jehier Afifi32, Andrzej Kajetanowicz33 5Victoria General Hospital, Victoria, BC, Canada; 6Women{\textquoteright}s Hospital and Health Centre, Vancouver, BC, Canada; 7Royal Columbian Hospital, New Westminster, BC, Canada; 8Surrey Memorial Hospital, Surrey, BC, Canada; 9Foothills Medical Centre, Calgary, AB, Canada; 10Royal Alexandra Hospital, Edmonton, AB, Canada; 11Alberta Children{\textquoteright}s Hospital, Calgary, AB, Canada; 12Regina General Hospital, Regina, SK, Canada; 13Royal University Hospital, Saskatoon, SK, Canada; 14Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 15St. Boniface General Hospital, Winnipeg, MB, Canada; 16Hamilton Health Sciences Centre, Hamilton, ON, Canada; 17London Health Sciences Centre, London, ON, Canada; 18Windsor Regional Hospital, Windsor, ON, Canada; 19Hospital for Sick Children, Toronto, ON, Canada; 20Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 21Children{\textquoteright}s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 22Kingston General Hospital, Kingston, ON, Canada; 23Jewish General Hospital, Montr{\'e}al, QC, Canada; 24H{\^o}pital Sainte-Justine, Montr{\'e}al, QC, Canada; 25Centre Hospitalier Universitaire de Qu{\'e}bec, Sainte Foy, QC, Canada; 26Montreal Children{\textquoteright}s Hospital at McGill University Health Centre, Montr{\'e}al, QC, Canada; 27Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 28Moncton Hospital, Moncton, NB, Canada; 29Dr. Everett Chalmers Hospital, Fredericton, NB, Canada;30Saint John Regional Hospital, Saint John, NB, Canada; 31Janeway Children{\textquoteright}s Health and Rehabilitation Centre, St. John{\textquoteright}s, NF, Canada; 32IWK Health Centre, Halifax, NS, Canada; 33Cape Breton Regional Hospital, Sydney, NS, Canada Author contributions VS conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. OE conceptualized and designed the study, and reviewed and revised the manuscript. PSS conceptualized and designed the study, Acknowledgements The authors gratefully acknowledge all site investigators and abstractors of the CNN. We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON, for organizational support of the CNN, CNFUN, and this project. In addition, we thank Sarah Hutchinson, PhD, and Iris Kulbatski, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding Information: Funding Although no specific funding has been received for this study, organizational support for the CNN was provided by the MiCare Research Centre at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a CIHR Team Grant (CTP 87518), the Ontario Ministry of Health and individual participating centers. Dr Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2020",

month = mar,

day = "1",

doi = "10.1038/s41372-019-0570-z",

language = "English",

volume = "40",

pages = "481--487",

journal = "Journal of Perinatology",

issn = "0743-8346",

publisher = "Nature Publishing Group",

number = "3",

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TY - JOUR

T1 - Outcomes of neonates born at <26 weeks gestational age who receive extensive cardiopulmonary resuscitation compared with airway and breathing support

AU - on behalf of the Canadian Neonatal Network Investigators

AU - Shukla, Vivek

AU - Elkhateeb, Omar

AU - Shah, Prakesh S.

AU - Yang, Junmin

AU - Lee, Kyong Soon

AU - Kanungo, Jaideep

AU - Ting, Joseph

AU - Cieslak, Zenon

AU - Sherlock, Rebecca

AU - Abou Mehrem, Ayman

AU - Toye, Jennifer

AU - Fajardo, Carlos

AU - Kalapesi, Zarin

AU - Bodani, Jaya

AU - Sankaran, Koravangattu

AU - Daspal, Sibasis

AU - Seshia, Mary

AU - Alvaro, Ruben

AU - Mukerji, Amit

AU - Da Silva, Orlando

AU - Nwaesei, Chuks

AU - Dunn, Michael

AU - Lemyre, Brigitte

AU - Khurshid, Faiza

AU - Pelausa, Ermelinda

AU - Barrington, Keith

AU - Lapointe, Anie

AU - Drolet, Christine

AU - Piedboeuf, Bruno

AU - Claveau, Martine

AU - Beltempo, Marc

AU - Bertelle, Valerie

AU - Masse, Edith

AU - Canning, Roderick

AU - Makary, Hala

AU - Ojah, Cecil

AU - Monterrosa, Luis

AU - Emberley, Julie

AU - Afifi, Jehier

AU - Kajetanowicz, Andrzej

N1 - Funding Information: Kanungo5, Joseph Ting6, Zenon Cieslak7, Rebecca Sherlock8, Ayman Abou Mehrem9, Jennifer Toye10, Carlos Fajardo11, Zarin Kalapesi12, and Jaya Bodani12, Koravangattu Sankaran13, and Sibasis Daspal13, Mary Seshia14, Ruben Alvaro15, Amit Mukerji16, Orlando Da Silva17, Chuks Nwaesei18, Kyong-Soon Lee19, Michael Dunn20, Brigitte Lemyre21, Faiza Khurshid22, Ermelinda Pelausa23, Keith Barrington24, and Anie Lapointe24, Christine Drolet25, and Bruno Piedboeuf25, Martine Claveau26, and Marc Beltempo26, Valerie Bertelle27, and Edith Masse27, Roderick Canning28, Hala Makary29, Cecil Ojah30, and Luis Monterrosa30, Julie Emberley31, Jehier Afifi32, Andrzej Kajetanowicz33 5Victoria General Hospital, Victoria, BC, Canada; 6Women’s Hospital and Health Centre, Vancouver, BC, Canada; 7Royal Columbian Hospital, New Westminster, BC, Canada; 8Surrey Memorial Hospital, Surrey, BC, Canada; 9Foothills Medical Centre, Calgary, AB, Canada; 10Royal Alexandra Hospital, Edmonton, AB, Canada; 11Alberta Children’s Hospital, Calgary, AB, Canada; 12Regina General Hospital, Regina, SK, Canada; 13Royal University Hospital, Saskatoon, SK, Canada; 14Winnipeg Health Sciences Centre, Winnipeg, MB, Canada; 15St. Boniface General Hospital, Winnipeg, MB, Canada; 16Hamilton Health Sciences Centre, Hamilton, ON, Canada; 17London Health Sciences Centre, London, ON, Canada; 18Windsor Regional Hospital, Windsor, ON, Canada; 19Hospital for Sick Children, Toronto, ON, Canada; 20Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 21Children’s Hospital of Eastern Ontario and Ottawa General Hospital, Ottawa, ON, Canada; 22Kingston General Hospital, Kingston, ON, Canada; 23Jewish General Hospital, Montréal, QC, Canada; 24Hôpital Sainte-Justine, Montréal, QC, Canada; 25Centre Hospitalier Universitaire de Québec, Sainte Foy, QC, Canada; 26Montreal Children’s Hospital at McGill University Health Centre, Montréal, QC, Canada; 27Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada; 28Moncton Hospital, Moncton, NB, Canada; 29Dr. Everett Chalmers Hospital, Fredericton, NB, Canada;30Saint John Regional Hospital, Saint John, NB, Canada; 31Janeway Children’s Health and Rehabilitation Centre, St. John’s, NF, Canada; 32IWK Health Centre, Halifax, NS, Canada; 33Cape Breton Regional Hospital, Sydney, NS, Canada Author contributions VS conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. OE conceptualized and designed the study, and reviewed and revised the manuscript. PSS conceptualized and designed the study, Acknowledgements The authors gratefully acknowledge all site investigators and abstractors of the CNN. We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON, for organizational support of the CNN, CNFUN, and this project. In addition, we thank Sarah Hutchinson, PhD, and Iris Kulbatski, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR) (CTP 87518), the Ontario Ministry of Health, and support from participating hospitals. Funding Information: Funding Although no specific funding has been received for this study, organizational support for the CNN was provided by the MiCare Research Centre at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a CIHR Team Grant (CTP 87518), the Ontario Ministry of Health and individual participating centers. Dr Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Objective: To evaluate outcomes of preterm infants <26 weeks gestational age (GA) following postdelivery extensive cardiopulmonary resuscitation (ECPR) compared with airway and breathing support (ABS). Study design: Retrospective review of Canadian Neonatal Network data during January 2010 to December 2016. The primary outcome was death or severe morbidity (intraventricular hemorrhage ≥grade 3 or periventricular leucomalacia, retinopathy of prematurity ≥stage 3, bronchopulmonary dysplasia, or necrotizing enterocolitis). Result: Among 3633 infants analyzed, 433 (11.9%) received ECPR. In multivariable analysis, death or severe morbidity was higher in the ECPR versus ABS group [adjusted odds ratio 2.26 (95% confidence interval 1.49, 3.43)]. The majority of the difference was due to increased mortality, which occurred mostly during the first week of life. Conclusion: These data from a recent cohort of infants near the limits of viability may be useful for prognostication for health care providers and counseling of parents.

AB - Objective: To evaluate outcomes of preterm infants <26 weeks gestational age (GA) following postdelivery extensive cardiopulmonary resuscitation (ECPR) compared with airway and breathing support (ABS). Study design: Retrospective review of Canadian Neonatal Network data during January 2010 to December 2016. The primary outcome was death or severe morbidity (intraventricular hemorrhage ≥grade 3 or periventricular leucomalacia, retinopathy of prematurity ≥stage 3, bronchopulmonary dysplasia, or necrotizing enterocolitis). Result: Among 3633 infants analyzed, 433 (11.9%) received ECPR. In multivariable analysis, death or severe morbidity was higher in the ECPR versus ABS group [adjusted odds ratio 2.26 (95% confidence interval 1.49, 3.43)]. The majority of the difference was due to increased mortality, which occurred mostly during the first week of life. Conclusion: These data from a recent cohort of infants near the limits of viability may be useful for prognostication for health care providers and counseling of parents.

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JO - Journal of Perinatology

JF - Journal of Perinatology

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ER -

Outcomes of neonates born at <26 weeks gestational age who receive extensive cardiopulmonary resuscitation compared with airway and breathing support

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