title: Definitions of cardiovascular insufficiency and relation to outcomes in critically ill newborn infants.
abstract: BACKGROUND
  We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants.
  
  
  OBJECTIVE
  This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death.
  
  
  METHODS
  The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed.
  
  
  RESULTS
  All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death.
  
  
  CONCLUSIONS
  The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Erika
authors.initials: E
authors.lastname: Fernandez
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Watterberg
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Roger G
authors.initials: RG
authors.lastname: Faix
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Yoder
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Michele C
authors.initials: MC
authors.lastname: Walsh
authors.affiliation: Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Conra Backstrom
authors.initials: CB
authors.lastname: Lacy
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Osborne
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Rockville, Maryland.
authors.forename: Abhik
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authors.lastname: Das
authors.affiliation: Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Kendrick
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Brenda B
authors.initials: BB
authors.lastname: Poindexter
authors.affiliation: Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island.
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
authors.affiliation: Department of Pediatrics, University of Texas Medical School at Houston, Houston, Texas.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Kennedy
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Kurt
authors.initials: K
authors.lastname: Schibler
authors.affiliation: Department of Pediatrics, University of Iowa, Iowa City, Iowa.
authors.forename: Edward F
authors.initials: EF
authors.lastname: Bell
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children&s Hospital, Palo Alto, California.
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Ivan D
authors.initials: ID
authors.lastname: Frantz
authors.affiliation: Department of Pediatrics, Duke University, Durham, North Carolina.
authors.forename: Ronald N
authors.initials: RN
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authors.affiliation: Department of Pediatrics, Wayne State University, Detroit, Michigan.
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.affiliation: Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.affiliation: Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sánchez
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, Maryland.
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
mesh_terms: D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000628:therapy*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D016014:Linear Models; D008297:Male; D010351:Patient Discharge; D054238:Perinatal Mortality; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*
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