PMID- 24876196 OWN - NLM STAT- MEDLINE DCOM- 20150303 LR - 20220318 IS - 1468-2052 (Electronic) IS - 1359-2998 (Print) IS - 1359-2998 (Linking) VI - 99 IP - 5 DP - 2014 Sep TI - Change in practice after the Surfactant, Positive Pressure and Oxygenation Randomised Trial. PG - F386-90 LID - 10.1136/archdischild-2014-306057 [doi] AB - OBJECTIVE: To test the hypothesis that the proportion of endotracheal intubation (ETI) in the delivery room (DR) decreased in Neonatal Research Network (NRN) centres after the National Institute of Child Health and Human Development NRN Surfactant, Positive Pressure, and Oxygenation Randomised Trial (SUPPORT). DESIGN: Retrospective cohort study using the prospective NRN generic database. SETTING: Eleven centres that participated in the SUPPORT trial and remained part of the NRN. Preterm neonates 24(0/7)-27(6/7) weeks' gestational age enrolled in the SUPPORT trial were randomised to: (1) DR continuous positive airway pressure or DR ETI with early surfactant administration; and (2) oxygen saturation targets of 85-89% or 91-95%. The prior NRN feasibility trial had assessed the feasibility of randomisation to continuous positive airway pressure versus ETI. PATIENTS: Infants 24(0/7)-27(6/7) weeks' gestational age, excluding infants with syndromes or major malformations and those on comfort care only. MAIN OUTCOME MEASURE: Proportion of DR ETI. RESULTS: The proportion of DR ETI decreased significantly in the group of infants from centres that had not participated in the feasibility trial (91% before vs 75% after SUPPORT, adjusted relative risk 0.86, 95% CI 0.83-0.89, p<0.0001) but not in the group of infants from the other centres, where the proportion of ETI was already lower prior to initiation of the SUPPORT trial (61% before vs 58% after SUPPORT, adjusted relative risk 0.96, 95% CI 0.89 to 1.05, p=0.40). CONCLUSION: This study shows that DR ETI changed after SUPPORT only in NRN centres that had not participated in a similar trial. TRIAL REGISTRATION NUMBER: NCT00063063 (GDB) and NCT00233324 (SUPPORT). CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. FAU - LeVan, Jaclyn M AU - LeVan JM AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA Pediatrix Medical Group, San Antonio, Texas, USA. FAU - Brion, Luc P AU - Brion LP AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA. FAU - Wrage, Lisa A AU - Wrage LA AD - Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina, USA. FAU - Gantz, Marie G AU - Gantz MG AD - Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina, USA. FAU - Wyckoff, Myra H AU - Wyckoff MH AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA. FAU - Sanchez, Pablo J AU - Sanchez PJ AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA. FAU - Heyne, Roy AU - Heyne R AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA. FAU - Jaleel, Mambarambath AU - Jaleel M AD - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA. FAU - Finer, Neil N AU - Finer NN AD - Division of Neonatology, University of California, San Diego, California, USA. FAU - Carlo, Waldemar A AU - Carlo WA AD - Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama, USA. FAU - Das, Abhik AU - Das A AD - Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina, USA. FAU - Stoll, Barbara J AU - Stoll BJ AD - Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA. FAU - Higgins, Rosemary D AU - Higgins RD AD - Eunice Kennedy Shriver National Institute of Child, Health and Human Development, Bethesda, Maryland, USA. CN - Eunice Kennedy Shriver NICHD Neonatal Research Network LA - eng SI - ClinicalTrials.gov/NCT00063063 SI - ClinicalTrials.gov/NCT00233324 GR - U10 HD27851/HD/NICHD NIH HHS/United States GR - U10 HD021385/HD/NICHD NIH HHS/United States GR - UL1 TR77/TR/NCATS NIH HHS/United States GR - UG1 HD087229/HD/NICHD NIH HHS/United States GR - U10 HD040461/HD/NICHD NIH HHS/United States GR - U10 HD027851/HD/NICHD NIH HHS/United States GR - UL1 TR001117/TR/NCATS NIH HHS/United States GR - UG1 HD068278/HD/NICHD NIH HHS/United States GR - UL1 TR371/TR/NCATS NIH HHS/United States GR - U10 HD027856/HD/NICHD NIH HHS/United States GR - U10 HD40689/HD/NICHD NIH HHS/United States GR - U10 HD021373/HD/NICHD NIH HHS/United States GR - UL1 TR93/TR/NCATS NIH HHS/United States GR - U10 HD40492/HD/NICHD NIH HHS/United States GR - U10 HD21364/HD/NICHD NIH HHS/United States GR - U10 HD34216/HD/NICHD NIH HHS/United States GR - U10 HD021364/HD/NICHD NIH HHS/United States GR - UL1 TR6/TR/NCATS NIH HHS/United States GR - U10 HD027880/HD/NICHD NIH HHS/United States GR - M01 RR70/RR/NCRR NIH HHS/United States GR - U10 HD36790/HD/NICHD NIH HHS/United States GR - U10 HD27880/HD/NICHD NIH HHS/United States GR - M01 RR008084/RR/NCRR NIH HHS/United States GR - U10 HD27904/HD/NICHD NIH HHS/United States GR - M01 RR633/RR/NCRR NIH HHS/United States GR - UL1 TR1117/TR/NCATS NIH HHS/United States GR - U10 HD040689/HD/NICHD NIH HHS/United States GR - U10 HD040492/HD/NICHD NIH HHS/United States GR - U10 HD027853/HD/NICHD NIH HHS/United States GR - U10 HD027904/HD/NICHD NIH HHS/United States GR - U10 HD27856/HD/NICHD NIH HHS/United States GR - U10 HD27853/HD/NICHD NIH HHS/United States GR - M01 RR39/RR/NCRR NIH HHS/United States GR - M01 RR30/RR/NCRR NIH HHS/United States GR - U10 HD40461/HD/NICHD NIH HHS/United States GR - UG1 HD034216/HD/NICHD NIH HHS/United States GR - UG1 HD027880/HD/NICHD NIH HHS/United States GR - M01 RR80/RR/NCRR NIH HHS/United States GR - M01 RR750/RR/NCRR NIH HHS/United States GR - M01 RR8084/RR/NCRR NIH HHS/United States GR - U10 HD21373/HD/NICHD NIH HHS/United States GR - U10 HD21385/HD/NICHD NIH HHS/United States GR - UL1 TR454/TR/NCATS NIH HHS/United States GR - M01 RR32/RR/NCRR NIH HHS/United States GR - U10 HD034216/HD/NICHD NIH HHS/United States GR - U10 HD036790/HD/NICHD NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural DEP - 20140529 PL - England TA - Arch Dis Child Fetal Neonatal Ed JT - Archives of disease in childhood. Fetal and neonatal edition JID - 9501297 RN - 0 (Pulmonary Surfactants) SB - IM MH - Bronchopulmonary Dysplasia/epidemiology/prevention & control MH - *Continuous Positive Airway Pressure MH - Databases, Factual MH - Delivery Rooms MH - Diffusion of Innovation MH - Feasibility Studies MH - Female MH - Humans MH - Infant, Extremely Premature MH - Infant, Newborn MH - Infant, Premature, Diseases/epidemiology/*therapy MH - Intensive Care, Neonatal/methods MH - Intubation, Intratracheal/statistics & numerical data MH - Male MH - *Oxygen Inhalation Therapy MH - Professional Practice/*statistics & numerical data MH - Pulmonary Surfactants/*therapeutic use MH - Randomized Controlled Trials as Topic/methods MH - Research Design MH - Retrospective Studies MH - United States/epidemiology PMC - PMC4134421 MID - NIHMS614228 OTO - NOTNLM OT - Clinical Procedures OT - Data Collection OT - Neonatology OT - Respiratory EDAT- 2014/05/31 06:00 MHDA- 2015/03/04 06:00 PMCR- 2014/09/01 CRDT- 2014/05/31 06:00 PHST- 2014/05/31 06:00 [entrez] PHST- 2014/05/31 06:00 [pubmed] PHST- 2015/03/04 06:00 [medline] PHST- 2014/09/01 00:00 [pmc-release] AID - archdischild-2014-306057 [pii] AID - 10.1136/archdischild-2014-306057 [doi] PST - ppublish SO - Arch Dis Child Fetal Neonatal Ed. 2014 Sep;99(5):F386-90. doi: 10.1136/archdischild-2014-306057. Epub 2014 May 29.