TY - JOUR
T1 - Epidemiology of Neonatal Acute Respiratory Distress Syndrome
T2 - Prospective, Multicenter, International Cohort Study
AU - de Luca, Daniele
AU - Tingay, David G.
AU - van Kaam, Anton H.
AU - van Tuijl, Minke
AU - Courtney, Sherry E.
AU - Kneyber, Martin C. J.
AU - Tissieres, Pierre
AU - Tridente, Ascanio
AU - Rimensberger, Peter C.
AU - Pillow, J. Jane
AU - Carnielli, Virgilio P.
AU - Nobile, Stefano
AU - Shi, Yuan
AU - Long, Chen
AU - Barcos, Francisca
AU - Hochberg, Amit
AU - Crocker, Caroline E.
AU - Harrison, Allen
AU - Perkins, Elizabeth
AU - Mosca, Fabio
AU - Mercadante, Domenica
AU - Raimondi, Francesco
AU - Capasso, Letizia
AU - Kallio, Merja
AU - Raschetti, Roberto
AU - Cillis, Annagrazia
AU - Soreze, Yohan
AU - Black, Lachlan
AU - Khan, Nash
AU - Piastra, Marco
AU - Conti, Giorgio
AU - Danhaive, Olivier
AU - Gibelli, Maria Augusta Bento Cicaroni
AU - de Carvalho, Werther Brunow
AU - Mulder, Estelle
N1 - Funding Information: Dr. De Luca received funding from Chiesi Farmaceutici S.p.A., Abbvie, Vyaire, Getinge, Medtronic, Masimo, Natus, Airway Therapeutics, and Ophirex; he disclosed that he served as a lecturer for Airway Therapeutics, Chiesi Farmaceutici S.p.A., Abbvie, Getinge, and Vyaire; he received nonfinancial research support from Chiesi Farmaceutici S.p.A. and Getinge; and he is a member of the advisory boards for Chiesi Farmaceutici S.p.A. and Ophirex. Dr. Tingay is supported by the Victorian Government Infrastructure Support Program. Drs. Tingay and Pillow received support for article research from the National Health and Medical Research Council (NHMRC) (Australia) Fellowships GNT1053889 and GNT1077691, respectively. Dr. van Kaam’s intuition received funding from Vyaire, Mallinckrodt, and Chiesi Farmaceutici S.p.A. Dr. Kneyber disclosed that he received nonfinancial research support from Vyaire and Applied Biosignals; he received funding from the National Heart, Lung, and Blood Institute, ZonMW, Stichting Vrienden Beatrix Kinderziekenhuis, and University Medical Center Groningen. Dr. Tissieres received funding from Sanofi, Inotrem, and Sedana. Dr. Pillow’s institution received funding from the NHMRC Centre of Research Excellence, the NHMRC Senior Research Fellowship, Chiesi Farmaceutici S.p.A., and Draeger Medical; she served as a consultant for Chiesi Farmaceutici S.p.A. and a lecturer for Draeger Medical; and she received product from Pari GmBH and Draeger Medical. All these relevant activities were outside the present work. The remaining authors have disclosed that they do not have any potential conflicts of interest. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - OBJECTIVES: Age-specific definitions for acute respiratory distress syndrome (ARDS) are available, including a specific definition for neonates (the "Montreux definition"). The epidemiology of neonatal ARDS is unknown. The objective of this study was to describe the epidemiology, clinical course, treatment, and outcomes of neonatal ARDS. DESIGN: Prospective, international, observational, cohort study. SETTING: Fifteen academic neonatal ICUs. PATIENTS: Consecutive sample of neonates of any gestational age admitted to participating sites who met the neonatal ARDS Montreux definition criteria. MEASUREMENTS AND MAIN RESULTS: Neonatal ARDS was classified as direct or indirect, infectious or noninfectious, and perinatal (≤ 72 hr after birth) or late in onset. Primary outcomes were: 1) survival at 30 days from diagnosis, 2) inhospital survival, and 3) extracorporeal membrane oxygenation (ECMO)-free survival at 30 days from diagnosis. Secondary outcomes included respiratory complications and common neonatal extrapulmonary morbidities. A total of 239 neonates met criteria for the diagnosis of neonatal ARDS. The median prevalence was 1.5% of neonatal ICU admissions with male/female ratio of 1.5. Respiratory treatments were similar across gestational ages. Direct neonatal ARDS (51.5% of neonates) was more common in term neonates and the perinatal period. Indirect neonatal ARDS was often triggered by an infection and was more common in preterm neonates. Thirty-day, inhospital, and 30-day ECMO-free survival were 83.3%, 76.2%, and 79.5%, respectively. Direct neonatal ARDS was associated with better survival outcomes than indirect neonatal ARDS. Direct and noninfectious neonatal ARDS were associated with the poorest respiratory outcomes at 36 and 40 weeks' postmenstrual age. Gestational age was not associated with any primary outcome on multivariate analyses. CONCLUSIONS: Prevalence and survival of neonatal ARDS are similar to those of pediatric ARDS. The neonatal ARDS subtypes used in the current definition may be associated with distinct clinical outcomes and a different distribution for term and preterm neonates.
AB - OBJECTIVES: Age-specific definitions for acute respiratory distress syndrome (ARDS) are available, including a specific definition for neonates (the "Montreux definition"). The epidemiology of neonatal ARDS is unknown. The objective of this study was to describe the epidemiology, clinical course, treatment, and outcomes of neonatal ARDS. DESIGN: Prospective, international, observational, cohort study. SETTING: Fifteen academic neonatal ICUs. PATIENTS: Consecutive sample of neonates of any gestational age admitted to participating sites who met the neonatal ARDS Montreux definition criteria. MEASUREMENTS AND MAIN RESULTS: Neonatal ARDS was classified as direct or indirect, infectious or noninfectious, and perinatal (≤ 72 hr after birth) or late in onset. Primary outcomes were: 1) survival at 30 days from diagnosis, 2) inhospital survival, and 3) extracorporeal membrane oxygenation (ECMO)-free survival at 30 days from diagnosis. Secondary outcomes included respiratory complications and common neonatal extrapulmonary morbidities. A total of 239 neonates met criteria for the diagnosis of neonatal ARDS. The median prevalence was 1.5% of neonatal ICU admissions with male/female ratio of 1.5. Respiratory treatments were similar across gestational ages. Direct neonatal ARDS (51.5% of neonates) was more common in term neonates and the perinatal period. Indirect neonatal ARDS was often triggered by an infection and was more common in preterm neonates. Thirty-day, inhospital, and 30-day ECMO-free survival were 83.3%, 76.2%, and 79.5%, respectively. Direct neonatal ARDS was associated with better survival outcomes than indirect neonatal ARDS. Direct and noninfectious neonatal ARDS were associated with the poorest respiratory outcomes at 36 and 40 weeks' postmenstrual age. Gestational age was not associated with any primary outcome on multivariate analyses. CONCLUSIONS: Prevalence and survival of neonatal ARDS are similar to those of pediatric ARDS. The neonatal ARDS subtypes used in the current definition may be associated with distinct clinical outcomes and a different distribution for term and preterm neonates.
KW - acute respiratory distress syndrome
KW - neonatal intensive care unit
KW - neonate
KW - outcome
KW - respiratory failure
UR - http://www.scopus.com/inward/record.url?scp=85134361077&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/PCC.0000000000002961
DO - https://doi.org/10.1097/PCC.0000000000002961
M3 - Article
C2 - 35543390
SN - 1529-7535
VL - 23
SP - 524
EP - 534
JO - Pediatric critical care medicine
JF - Pediatric critical care medicine
IS - 7
ER -