Validity of biomarkers of early circulatory impairment to redict outcome: A retrospective analysis
Entity
UAM. Departamento de Pediatría; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Publisher
Frontiers MediaDate
2019-05-29Citation
10.3389/fped.2019.00212
Frontiers in Pediatrics 7.May (2019): 1-8
ISSN
2296-2360DOI
10.3389/fped.2019.00212Funded by
The work was partially supported by NEO-CIRC FP7-HEALTH grant (agreement no: 282533). We also acknowledge the SAMID network (RETICS funded by the PN 2018-2011 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion and European Regional Development Fund (FEDER), ref. RD12/0026 and the Spanish Ministry of Health (SAS/2481/2009) for the scientific and financial support, respectivelyProject
info:eu-repo/grantAgreement/EC/FP7/282533; Gobierno de España. RD12/0026; Gobierno de España. SAS/2481/2009Editor's Version
https://doi.org/10.3389/fped.2019.00212Subjects
Transitional circulation; Circulatory impairment; Cardiovascular treatment; Hypotension; Preterm; MedicinaRights
© 2019 Bravo, López-Ortego, Sánchez, Madero, Cabaañas, Koch, Rojas- Anaya, Rabe and PellicerAbstract
Objectives: The definition of circulatory impairment in the premature infant is
controversial. Current research suggests overdiagnosis and overtreatment. We aimed to
analyse which biomarkers move clinicians to initiate cardiovascular treatment (CVT). The
prognostic capacity for adverse outcome (death and/or moderate-severe brain damage
by cranial ultrasound at term equivalent) of these biomarkers was evaluated.
Study Design: Retrospective data analysis from preterm infants enrolled in a
placebo-controlled trial on dobutamine for low superior vena cava (SVC) flow, who
showed normal SVC flow within the first 24 h (not randomized). Five positive biomarkers
were considered: MABP < gestational age (GA)-1 mmHg; MABP < GA-5 mmHg; lactate
> 4 mmol/L; BE < −9 mmol/L; SVC flow <51 ml/kg/min.
Results: Ninety eight infants formed the study cohort. Thirty six received CVT (2–95 h).
Logistic regression models adjusted for gestational age showed a positive association
between CVT and the risk of death or moderate-severe abnormal cranial ultrasound at
termequivalent [(OR 5.2, 95%CI: 1.8–15.1) p=0.002].MABP<GA-1mmHg and lactate
> 4 mmol/L were the most prevalent biomarkers at start of treatment. Low BE, high
serum lactate and low SVC flow at first echocardiography showed a trend toward being
associated with adverse outcome, although not statistically significant.
Conclusions: Low blood pressure and high lactate are the most prevalent biomarkers
used for CVT prescription. Lactic acidosis and low SVC flow early after birth showed
a trend toward being associated with adverse outcome. These findings support using
a combination of biomarkers for inclusion in a placebo-controlled trial on CVT during
transitional circulation
Files in this item
Google Scholar:Bravo, María Carmen
-
López-Ortego, Paloma
-
Sánchez, Laura
-
Madero, Rosario
-
Cabañas, Fernando
-
Koch, Armin
-
Rojas-Anaya, Héctor
-
Rabe, Heike
-
Pellicer Martínez, Adelina
-
NeoCirculation Consortium (NEO-CIRC)
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.
-
Genetic landscape of 6089 inherited retinal dystrophies affected cases in Spain and their therapeutic and extended epidemiological implications
Perea-Romero, Irene; Gordo, Gema; Iancu, Ionut F.; Del Pozo-Valero, Marta; Almoguera, Berta; Blanco-Kelly, Fiona; Carreño, Ester; Jimenez-Rolando, Belen; Lopez-Rodriguez, Rosario; Lorda-Sanchez, Isabel; Martin-Merida, Inmaculada; Pérez de Ayala, Lucia; Riveiro-Alvarez, Rosa; Rodriguez-Pinilla, Elvira; Tahsin-Swafiri, Saoud; Trujillo-Tiebas, Maria J.; Bustamante-Aragones, Ana; Cardero-Merlo, Rocio; Fernandez-Sanchez, Ruth; Gallego-Merlo, Jesus; Garcia-Vara, Ines; Gimenez-Pardo, Ascension; Horcajada-Burgos, Laura; Infantes-Barbero, Fernando; Lantero, Esther; Lopez-Martinez, Miguel A.; Martinez-Ramas, Andrea; Ondo, Lorena; Rodriguez de Alba, Marta; Sanchez-Jimeno, Carolina; Velez-Monsalve, Camilo; Villaverde, Cristina; Zurita, Olga; Aguilera-Garcia, Domingo; Aguirre-Lamban, Jana; Arteche, Ana; Cantalapiedra, Diego; Fernandez-San Jose, Patricia; Galbis-Martinez, Liliana; Garcia-Hoyos, Maria; Lombardia, Carlos; Lopez-Molina, Maria I.; Perez-Carro, Raquel; Da Silva, Luciana R.J.; Ramos, Carmen; Sanchez-Alcudia, Rocio; Sanchez-Navarro, Iker; Tatu, Sorina D.; Vallespin, Elena; Aller, Elena; Bernal, Sara; Gamundi, Maria J.; Garcia-Garcia, Gema; Hernan, Inmaculada; Jaijo, Teresa; Antiñolo, Guillermo; Baiget, Montserrat; Carballo, Miguel; Millan, Jose M.; Valverde, Diana; Allikmets, Rando; Banfi, Sandro; Cremers, Frans P.M.; Collin, Rob W.J.; De Baere, Elfride; Hakonarson, Hakon; Kohl, Susanne; Rivolta, Carlo; Sharon, Dror; Alonso-Cerezo, Maria C.; Ballesta-Martinez, Maria J.; Beltran, Sergi; Benito Lopez, Carmen; Català-Mora, Jaume; Catalli, Claudio; Cotarelo-Perez, Carmen; Fernandez-Burriel, Miguel; Fontalba-Romero, Ana; Galán-Gómez, Enrique; Garcia-Barcina, Maria; Garcia-Cruz, Loida M.; Gener, Blanca; Gil-Fournier, Belen; Govea, Nancy; Guillen-Navarro, Encarna; Hernando Acero, Ines; Irigoyen, Cristina; Izquierdo-Álvarez, Silvia; Llano-Rivas, Isabel; López-Ariztegui, Maria A.; Lopez-Gonzalez, Vanesa; Lopez-Grondona, Fermina; Martorell, Loreto; Mendez-Perez, Pilar; Moreno-Igoa, Maria; Oancea-Ionescu, Raluca; Palau-Martinez, Francesc; Perez de Nanclares, Guiomar; Ramos-Fuentes, Feliciano J.; Rodriguez-Lopez, Raquel; Ayuso García, María del Carmen Tomasa
2021-12-01 -
The evolving microbiome from pregnancy to early infancy: A comprehensive review
Mesa, María Dolores; Loureiro, Begoña; Iglesia, Iris; Fernández González, Segi; Llurba Olivé, Elisa; García Algar, Óscar; Solana, María José; Cabero Pérez, Mª Jesús; Sainz, Talia; Martínez, Leopoldo; Escuder-Vieco, Diana; Parra-Llorca, Anna; Sánchez-Campillo, María; Rodriguez Martinez, Gerardo; Gómez Roig, Dolores; Pérez Gruz, Myriam; Andreu-Fernández, Vicente; Clotet, Jordi; Sailer, Sebastián; Iglesias-Platas, Isabel; López-Herce, Jesús; Aras, Rosa; Pallás-Alonso, Carmen; Sáenz de Pipaón Marcos, Miguel; Vento, Máximo; Gormaz, María; Larqué Daza, Elvira; Calvo, Cristina; Cabañas, Fernando
2020-01-02 -
Long runs of homozygosity are associated with Alzheimer's disease
Moreno-Grau, Sonia; Fernández, María Víctoria; de Rojas, Itziar; García-González, Pablo; Hernández, Isabel; Farias, Fabiana; Budde, John P.; Quintela, Inés; Madrid, Laura; González-Pérez, António; Montrreal, Laura; Alarcón-Martín, Emilio; Alegret, Montserrat; Maronas, Olalla; Pineda, Juan António; Macias, Juan; Marquie, Marta; Valero, Sergi; Benaque, Alba; Clarimon, Jordi; Bullido Gómez-Heras, María Jesús; García-Ribas, Guillermo; Pastor, Pau; Sánchez-Juan, Pascual; Álvarez, Víctoria; Pinol-Ripoll, Gerard; García-Alberca, José Maria; Royo, José Luis; Franco-Macias, Emilio; Mir, Pablo; Calero, Miguel; Medina, Miguel; Rábano, Alberto; Ávila, Jesús; Antúnez, Carmen; Real, Luis Miguel; Orellana, Adelina; Carracedo, Ángel; Sáez, María Eugenia; Tarraga, Lluis; Boada, Merce; Cruchaga, Carlos; Ruiz, Agustín; GR ACE Study groupDEGESCO Consortium; Alzheimer's Dis Neuroimaging Initiative
2021-02-24