Trial reportArchives of disease in childhood. Fetal and neonatal edition2015
PaCO2 in surfactant, positive pressure, and oxygenation randomised trial (SUPPORT).
Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00233324 (Surfactant Positive Airway Pressure and Pulse Oximetry Trial), which is not on this map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT) in Extremely Low Birth Weight Infants
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Thresholds for surfactant use in preterm neonates: a network meta-analysis.Archives of disease in childhood. Fetal and neonatal edition · 2023Pooled it
- Carbon dioxide levels in neonates: what are safe parameters?Pediatric research · 2022Pooled it
- Porcine versus bovine surfactant therapy for RDS in preterm neonates: pragmatic meta-analysis and review of physiopathological plausibility of the effects on extra-pulmonary outcomes.Respiratory research · 2020Pooled it
- Late permissive hypercapnia and respiratory stability among very preterm infants: a pilot randomised trial.Archives of disease in childhood. Fetal and neonatal edition · 2023Trial
- Japan at the limits of viability: national experience and evolving outcomes of infants born at 22-23 weeks' gestation.Pediatric research · 2026Review
- First week of life respiratory management and pulmonary ventilation/perfusion matching in infants with bronchopulmonary dysplasia: a retrospective observational study.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Transcutaneous carbon dioxide pattern and trend over time in preterm infants.Pediatric research · 2021Article
- Effect of electrode temperature on measurements of transcutaneous carbon dioxide partial pressure and oxygen partial pressure in very low birth weight infants.Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- Does prolonged severe hypercapnia interfere with normal cerebrovascular function in piglets?Pediatric research · 2018Article
- Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment.Turk pediatri arsivi · 2018Article
- Newborn blood gas derangements of children born extremely preterm and neurocognitive dysfunctions at age 10 years.Respiratory physiology & neurobiology · 2017Observational
- Implementing Volume-targeted Ventilation to Decrease Hypocarbia in Extremely Low Birth Weight Infants during the First Week of Life: A Quality Improvement Project.Pediatric quality & safetyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveTo determine the association of arterial partial pressure of carbon dioxide PaCO2 with severe intraventricular haemorrhage (sIVH), bronchopulmonary dysplasia (BPD), and neurodevelopmental impairment (NDI) at 18-22 months in premature infants.
designSecondary exploratory data analysis of Surfactant, Positive Pressure, and Oxygenation Randomised Trial (SUPPORT).
settingMultiple referral neonatal intensive care units. PATIENTS: 1316 infants 24 0/7 to 27 6/7 weeks gestation randomised to different oxygenation (SpO2 target 85-89% vs 91-95%) and ventilation strategies.
main outcome measuresBlood gases from postnatal day 0 to day14 were analysed. Five PaCO2 variables were defined: minimum (Min), maximum (Max), SD, average (time-weighted), and a four level categorical variable (hypercapnic (highest quartile of Max PaCO2), hypocapnic (lowest quartile of Min PaCO2), fluctuators (hypercapnia and hypocapnia), and normocapnic (middle two quartiles of Max and Min PaCO2)). PaCO2 variables were compared for infants with and without sIVH, BPD and NDI (±death). Multivariable logistic regression models were developed for adjusted results.
resultssIVH, BPD and NDI (±death) were associated with hypercapnic infants and fluctuators. Association of Max PaCO2 and outcomes persisted after adjustment (per 10 mm Hg increase: sIVH/death: OR 1.27 (1.13 to 1.41); BPD/death: OR 1.27 (1.12 to 1.44); NDI/death: OR 1.23 (1.10 to 1.38), death: OR 1.27 (1.12 to 1.44), all p<0.001). No interaction was found between PaCO2 category and SpO2 treatment group for sIVH/death, NDI/death or death. Max PaCO2 was positively correlated with maximum FiO2 (rs0.55, p<0.0001) and ventilator days (rs0.61, p<0.0001).
conclusionsHigher PaCO2 was an independent predictor of sIVH/death, BPD/death and NDI/death. Further trials are needed to evaluate optimal PaCO2 targets for high-risk infants.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.