Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 32, Issue 1, Pages 9-14Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0034-1371703
Keywords
infant; premature; inotrope; mortality; morbidity; variation
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Funding
- Mount Sinai Hospital
- Canadian Institutes for Health Research
- Ontario Ministry of Health and Long-Term Care, Canada
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ObjectiveTo compare neonatal outcomes between infants who received inotropes and those who did not, and identify variation in inotrope use. Study DesignRetrospective review of data from neonates<29 weeks gestation collected by the Canadian Neonatal Network during 2003 to 2010. After controlling for confounders and maternal/infant characteristics, rates of mortality and major morbidity were compared between those who received inotropes on days 1 and 3 of admission and those who did not. Rate of inotrope use was compared between sites. ResultsInotropes were administered to 772 (10%) of the 7,913 neonates. Infants who received inotropes had significantly higher illness severity, surfactant use, and need for mechanical ventilation. Inotrope use was also associated with significantly higher rates of mortality (adjusted odds ratio [AOR]=2.05 [1.64, 2.57]), retinopathy of prematurity (AOR=2.04 [1.54, 2.71]), intraventricular hemorrhage (AOR=1.59 [1.29, 1.93]), bronchopulmonary dysplasia (AOR=1.38 [1.11, 1.72]), and necrotizing enterocolitis (AOR=2.06 [1.59, 2.67]). Rates of inotrope use varied significantly between participating sites (0-36%; AOR=0 [0, 0.1]-7.7 [2.9, 21]). ConclusionRisk of mortality and major morbidities were significantly higher in neonates who received inotropes. Inotrope use varied significantly among Canadian neonatal intensive care units.
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