Outcomes of infants with birthweights less than 501 g compared to infants weighing 501-750 g at a center utilizing first intention high frequency jet ventilation

• Main Authors: Timothy G. Elgin (Author), Jennifer N. Berger (Author), Dinushan C. Kaluarachchi (Author), John M. Dagle (Author), Brady Thomas (Author), Tarah T. Colaizy (Author), Jonathan M. Klein (Author)
• Format: Book
• Published: Frontiers Media S.A., 2024-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

BackgroundData on clinical outcomes of infants with birthweights less than 501 g (ELBW<501) are limited.ObjectiveTo evaluate management strategies and clinical outcomes of ELBW<501infants compared to infants weighing 501-750 g (ELBW501-750).MethodsA retrospective study of all ELBW<501 and ELBW501-750 infants born between 2012 and 2022 at a center utilizing first intention high frequency jet ventilation was performed. Patient characteristics, clinical and outcome data were compared between the two groups.ResultsA total of 358 infants (92 ELBW<501 infants and 266 ELBW501-750) were included. The survival rate for the ELBW<501 group was 60.9% compared to 86.5% for ELBW501-750. ELBW<501 infants required more frequent use of 2.0 mm endotracheal tubes, required higher FiO2 and longer duration of mechanical ventilation. Compared to ELBW501-750 group, the ELBW<501 group were more likely to be SGA (68.2% vs. 16.5%) and more premature (23.2 vs. 24.3 weeks) with lower survival, longer length of stay, higher incidence of ROP and lower weight at discharge but comparable rates of IVH, grade 3 BPD, discharged on supplemental oxygen, and tracheostomy.ConclusionELBW<501 infants are at risk for significant morbidity and mortality. However, with specialized obstetric and neonatal care, survival rates of 60% are possible with respiratory outcomes comparable to ELBW501-750 infants. However, the increased risk of severe ROP for ELBW<501 requiring either surgical or medical intervention is concerning and warrants optimal surveillance.

Item Description

2296-2360
10.3389/fped.2024.1392079