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| Name | Class |
|---|---|
| Banner Health | OTHER |
| Phoenix Children's Hospital | OTHER |
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Assess the impact of steroid, diuretic, and fluid practices on BPD outcomes in extreme premature infants in the Banner - University Medical Center Phoenix (BUMCP) neonatal intensive care unit (NICU).
The investigators propose performing a retrospective analysis of the current respiratory management methods to potentially find a correlation between the number of steroid doses administered, the timing of initiation of steroid therapy and the effect on premature infants at risk for developing BPD. The investigators are also going to explore the number and timing of diuretic medications and average fluid intake.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inclusion Group | Infants born at <30 weeks and/or <1500g that were admitted to BUMCP between January 1, 2019 and December 31, 2020 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No interventions or procedures | Other | This is a retrospective observational study and data will be collected from the subject's existing medical record. No interventions or procedures will be required for this study. |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the impact of steroid practices on BPD outcomes in these infants | - The incidence of BPD stratified into three stages based on the type of support required at 36 weeks CGA | 30 days |
| To assess the impact of steroid practices on BPD outcomes in these infants | - Presence of prenatal steroid administration | 30 days |
| To assess the impact of steroid practices on BPD outcomes in these infants | - Administration of steroids to the infant | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| To determine if steroid use has an impact on infant growth | - Collect growth and calculate the z-score at five intervals | 30 days |
| To determine if steroid use has an impact on NICU length of stay (LOS) |
| Measure | Description | Time Frame |
|---|---|---|
| To determine if the average fluid intake in the first week of life influences the severity of BPD | - Fluid average from DOL 1-6 | 1-6 days |
| To determine if diuretic administration influences the severity of BPD |
Inclusion Criteria:
Exclusion Criteria:
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Infants admitted to the BUMCP NICU at <30 weeks and/or <1500 grams (g)
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| Name | Affiliation | Role |
|---|---|---|
| Alejandra Valladolid, MD | Banner University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Banner University Medical Center Phoenix | Phoenix | Arizona | 85006 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 5334613 | Background | Northway WH Jr, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967 Feb 16;276(7):357-68. doi: 10.1056/NEJM196702162760701. No abstract available. | |
| 25738785 | Background | Guaman MC, Gien J, Baker CD, Zhang H, Austin ED, Collaco JM. Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia. Am J Perinatol. 2015 Aug;32(10):960-7. doi: 10.1055/s-0035-1547326. Epub 2015 Mar 4. |
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| ID | Term |
|---|---|
| D001997 | Bronchopulmonary Dysplasia |
| ID | Term |
|---|---|
| D055397 | Ventilator-Induced Lung Injury |
| D055370 | Lung Injury |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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- NICU LOS in days
| 30 days |
- If applicable, the DOL of first furosemide and/or chlorothiazide doses
| 1-6 days |
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| 18595991 | Background | Onland W, De Jaegere AP, Offringa M, van Kaam AH. Effects of higher versus lower dexamethasone doses on pulmonary and neurodevelopmental sequelae in preterm infants at risk for chronic lung disease: a meta-analysis. Pediatrics. 2008 Jul;122(1):92-101. doi: 10.1542/peds.2007-2258. |
| 19117904 | Background | Onland W, Offringa M, De Jaegere AP, van Kaam AH. Finding the optimal postnatal dexamethasone regimen for preterm infants at risk of bronchopulmonary dysplasia: a systematic review of placebo-controlled trials. Pediatrics. 2009 Jan;123(1):367-77. doi: 10.1542/peds.2008-0016. |
| 20150750 | Background | Doyle LW, Ehrenkranz RA, Halliday HL. Postnatal hydrocortisone for preventing or treating bronchopulmonary dysplasia in preterm infants: a systematic review. Neonatology. 2010;98(2):111-7. doi: 10.1159/000279992. Epub 2010 Feb 12. |
| 26058477 | Background | Peltoniemi OM, Lano A, Yliherva A, Kari MA, Hallman M; Neonatal Hydrocortisone Working Group. Randomised trial of early neonatal hydrocortisone demonstrates potential undesired effects on neurodevelopment at preschool age. Acta Paediatr. 2016 Feb;105(2):159-64. doi: 10.1111/apa.13074. Epub 2015 Nov 5. |
| 26916176 | Background | Baud O, Maury L, Lebail F, Ramful D, El Moussawi F, Nicaise C, Zupan-Simunek V, Coursol A, Beuchee A, Bolot P, Andrini P, Mohamed D, Alberti C; PREMILOC trial study group. Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial. Lancet. 2016 Apr 30;387(10030):1827-36. doi: 10.1016/S0140-6736(16)00202-6. Epub 2016 Feb 23. |
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| D007235 |
| Infant, Premature, Diseases |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |