To determine the relationship between maximum vasoactive-inotropic (VISmax) and mortality in extremely premature (<29 weeks completed gestation), extremely low birth weight (ELBW, <1000 g) infants.
Single center, retrospective, and observational cohort study.
We identified 436 ELBW, <29 week, inborn infants cared for during the study period. Compared to infants with VISmax of 0, the frequency of mortality based on VISmax ranged from 3.3-fold to 46.1-fold. VISmax > 30 was associated with universal mortality. Multivariable modeling that included gestational age, birth weight, and VISmax revealed significant utility to predict mortality with negative predictive value of 87.0% and positive predictive value of 84.8% [adjusted AUROC: 0.90, (0.86–0.94)] among patients that received vasoactive-inotropic treatment.
VISmax is an objective measure of hemodynamic/cardiovascular support that was directly associated with mortality in extremely premature ELBW infants. The VISmax represents an important step towards neonatal precision medicine and risk stratification of extremely premature ELBW infants.
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This work was not directly supported. JLW receives support from the National Institutes of Health (NIH; R01GM128452; R01HD089939, R01HD097081, R43EB029863).
Conflict of interest
The authors declare no competing interests.
This study was approved by the Institutional Review Board at the University Of Florida (IRB201902780). The study was performed in accordance with the Declaration of Helsinki.
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Aziz, K.B., Lavilla, O.C., Wynn, J.L. et al. Maximum vasoactive-inotropic score and mortality in extremely premature, extremely low birth weight infants. J Perinatol 41, 2337–2344 (2021). https://doi.org/10.1038/s41372-021-01030-9
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