Document Detail

Risk factors and clinical outcomes of pulmonary interstitial emphysema in extremely low birth weight infants.
MedLine Citation:
PMID:  16493434     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We studied the ante- and postnatal risk factors and clinical outcomes associated with pulmonary interstitial emphysema (PIE) in extremely low birth weight infants (ELBW, <1000 g at birth) in the present era of tocolytics, antenatal steroid and postnatal surfactant administration. STUDY DESIGN: This was a retrospective case-controlled study of all ELBW admitted consecutively during a designated study-period in a level III nursery. Data were analyzed by performing univariate and multivariate analysis as applicable. RESULTS: Infants with PIE had lower 1 and 5 min Apgar scores (P=0.04 and 0.003 respectively), increased surfactant utilization (P=0.004), higher maximum inspired oxygen concentration (P=0.04) and mean airway pressure administration (P=0.02) during the first week of life, and increased neonatal mortality (P=0.01). They received higher antenatal doses of magnesium sulfate (MgSO(4)) (P=0.02). 56% of infants with PIE were exposed to more than 10 g of MgSO(4) (Mg10), compared to 15% in non-PIE group (P=0.01). The multivariate logistic regression analysis including significant co-variates revealed an independent association between Mg10 and PIE (P=0.01, Odds ratio 19.8, 95% CI 1.5-263). CONCLUSION: Pulmonary interstitial emphysema is associated with increased mortality in ELBW infants. Mg10 is an independent risk factor for PIE in this population.
R P Verma; S Chandra; R Niwas; E Komaroff
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  26     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-22     Completed Date:  2006-06-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-200     Citation Subset:  IM    
Department of Pediatrics, SUNY School of Medicine, Stony Brook, NY 11794-8111, USA.
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MeSH Terms
Apgar Score
Case-Control Studies
Follow-Up Studies
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal
Oxygen / therapeutic use
Pulmonary Emphysema / epidemiology*,  etiology*,  physiopathology
Respiration, Artificial / methods
Respiratory Distress Syndrome, Newborn / diagnosis,  therapy*
Retrospective Studies
Risk Assessment
Survival Rate
Treatment Outcome
Grant Support
5-M01-RR-10710/RR/NCRR NIH HHS
Reg. No./Substance:
Comment In:
J Perinatol. 2006 Aug;26(8):521-2; author reply 522-3   [PMID:  16871225 ]

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