Dec. 26, 2012 — By the time they reached toddlerhood, very preterm infants originally treated with higher oxygen levels continued to show benefits when compared to a group treated with lower oxygen levels, according to a follow-up study by a research network of the National Institutes of Health that confirms earlier network findings, Moreover, infants treated with a respiratory therapy commonly prescribed for adults with obstructive sleep apnea fared as well as those who received the traditional therapy for infant respiratory difficulties, the new study found.
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In the original 2010 study, of infants born between 24 to 27 weeks of gestation, investigators in the Neonatal Research Network found:
In terms of the primary outcome, the researchers found no differences between the groups.
When the researchers looked at outcome measures separately, however, they did observe differences. The researchers documented higher survival rates among children who received oxygen with higher saturation rates. The study's original findings showed that survivors in this group also had a greater risk of developing retinopathy of prematurity, an eye condition that can impair vision or cause blindness. Although those receiving higher oxygen levels were more likely to have had corrective eye surgery, by the time the children reached 18 to 22 months corrected age-- their age had they been born at the approximate time they were due. The researchers found that there was no difference in the rate of vision problems between the two groups.
"CPAP for infants has been available since the 1970s. This is the first study to compare surfactant treatment to CPAP in a large group of infants, and these results reassure us that CPAP is as good a choice in the first hour of life as traditional methods for very preterm babies who need help breathing," said senior author Rosemary D. Higgins, M.D., of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), one of two NIH institutes supporting the study. "We've also confirmed that higher oxygen targets improve survival and don't appear to threaten survivors' vision in the longer term."
The study also received funding from the National Heart, Lung and Blood Institute.
Their findings appear in the New England Journal of Medicine.
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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
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In the original 2010 study, of infants born between 24 to 27 weeks of gestation, investigators in the Neonatal Research Network found:
- Infants were more likely to survive if they had received higher oxygen levels, although they were at higher risk of an eye condition that can impair vision or lead to blindness.
- Continuous positive airway pressure (CPAP), a treatment typically reserved for adults with obstructive sleep apnea, was as effective as standard therapy with a ventilator and surfactant (a sticky substance that coats the inside of the lungs).
- Children treated with oxygen saturation levels that were either low (85 percent to 89 percent) or high (91 percent to 95 percent).
- Children treated with CPAP therapy and those treated with a ventilator and surfactant.
In terms of the primary outcome, the researchers found no differences between the groups.
When the researchers looked at outcome measures separately, however, they did observe differences. The researchers documented higher survival rates among children who received oxygen with higher saturation rates. The study's original findings showed that survivors in this group also had a greater risk of developing retinopathy of prematurity, an eye condition that can impair vision or cause blindness. Although those receiving higher oxygen levels were more likely to have had corrective eye surgery, by the time the children reached 18 to 22 months corrected age-- their age had they been born at the approximate time they were due. The researchers found that there was no difference in the rate of vision problems between the two groups.
"CPAP for infants has been available since the 1970s. This is the first study to compare surfactant treatment to CPAP in a large group of infants, and these results reassure us that CPAP is as good a choice in the first hour of life as traditional methods for very preterm babies who need help breathing," said senior author Rosemary D. Higgins, M.D., of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), one of two NIH institutes supporting the study. "We've also confirmed that higher oxygen targets improve survival and don't appear to threaten survivors' vision in the longer term."
The study also received funding from the National Heart, Lung and Blood Institute.
Their findings appear in the New England Journal of Medicine.
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The above story is reprinted from materials provided by NIH/National Institute of Child Health and Human Development.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Journal Reference:
- Yvonne E. Vaucher, Myriam Peralta-Carcelen, Neil N. Finer, Waldemar A. Carlo, Marie G. Gantz, Michele C. Walsh, Abbot R. Laptook, Bradley A. Yoder, Roger G. Faix, Abhik Das, Kurt Schibler, Wade Rich, Nancy S. Newman, Betty R. Vohr, Kimberly Yolton, Roy J. Heyne, Deanne E. Wilson-Costello, Patricia W. Evans, Ricki F. Goldstein, Michael J. Acarregui, Ira Adams-Chapman, Athina Pappas, Susan R. Hintz, Brenda Poindexter, Anna M. Dusick, Elisabeth C. McGowan, Richard A. Ehrenkranz, Anna Bodnar, Charles R. Bauer, Janell Fuller, T. Michael O'Shea, Gary J. Myers, Rosemary D. Higgins. Neurodevelopmental Outcomes in the Early CPAP and Pulse Oximetry Trial. New England Journal of Medicine, 2012; 367 (26): 2495 DOI: 10.1056/NEJMoa1208506
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.