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Retrospective study of short-term complications associated with early morphine use in intubated premature infants

Relieving neonatal pain is essential for the management of premature infants. Morphine is the most frequently used analgesic in neonatal intensive care. Here we report the relationship between early morphine infusion and the composite outcome of intraventricular hemorrhage and/or death in intubated...

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Autores principales: Al-Mouqdad, Mountasser M., Khalil, Thanaa M., Asfour, Suzan S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331726/
https://www.ncbi.nlm.nih.gov/pubmed/32616894
http://dx.doi.org/10.1038/s41598-020-67891-w
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author Al-Mouqdad, Mountasser M.
Khalil, Thanaa M.
Asfour, Suzan S.
author_facet Al-Mouqdad, Mountasser M.
Khalil, Thanaa M.
Asfour, Suzan S.
author_sort Al-Mouqdad, Mountasser M.
collection PubMed
description Relieving neonatal pain is essential for the management of premature infants. Morphine is the most frequently used analgesic in neonatal intensive care. Here we report the relationship between early morphine infusion and the composite outcome of intraventricular hemorrhage and/or death in intubated premature infants. Infants (gestational age ≤ 32 weeks and birth weight < 1,500 g) intubated on admission were retrospectively evaluated in a large tertiary neonatal intensive care unit. Modified log-Poisson regression with robust variance estimator and Cox regression was applied to adjust the relative risk for infants’ outcomes. Of 420 premature infants, 230 (54.7%) received continuous morphine infusion in the first 72 h. Of these, 153 were < 28 gestational weeks; of the 190 patients who did not receive morphine, 63 were < 28 gestational weeks. The analysis revealed that infants < 28 gestational weeks who received morphine were significantly associated with an increased risk for IVH and/or death [adjusted relative risk (aRR) 1.37, 95% confidence interval (CI) 1.1–1.71)], and mortality (aRR 1.83, 95% CI 1.17–2.89). Moreover, in infants < 28 gestational weeks, survival was low in those infants who were exposed to morphine infusion in the first 72 h (hazard ratio 2.11; 95% CI 1.19–3.73). Early morphine infusion is associated with an increased risk for IVH and/or death; however, further studies are required to verify our findings.
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spelling pubmed-73317262020-07-06 Retrospective study of short-term complications associated with early morphine use in intubated premature infants Al-Mouqdad, Mountasser M. Khalil, Thanaa M. Asfour, Suzan S. Sci Rep Article Relieving neonatal pain is essential for the management of premature infants. Morphine is the most frequently used analgesic in neonatal intensive care. Here we report the relationship between early morphine infusion and the composite outcome of intraventricular hemorrhage and/or death in intubated premature infants. Infants (gestational age ≤ 32 weeks and birth weight < 1,500 g) intubated on admission were retrospectively evaluated in a large tertiary neonatal intensive care unit. Modified log-Poisson regression with robust variance estimator and Cox regression was applied to adjust the relative risk for infants’ outcomes. Of 420 premature infants, 230 (54.7%) received continuous morphine infusion in the first 72 h. Of these, 153 were < 28 gestational weeks; of the 190 patients who did not receive morphine, 63 were < 28 gestational weeks. The analysis revealed that infants < 28 gestational weeks who received morphine were significantly associated with an increased risk for IVH and/or death [adjusted relative risk (aRR) 1.37, 95% confidence interval (CI) 1.1–1.71)], and mortality (aRR 1.83, 95% CI 1.17–2.89). Moreover, in infants < 28 gestational weeks, survival was low in those infants who were exposed to morphine infusion in the first 72 h (hazard ratio 2.11; 95% CI 1.19–3.73). Early morphine infusion is associated with an increased risk for IVH and/or death; however, further studies are required to verify our findings. Nature Publishing Group UK 2020-07-02 /pmc/articles/PMC7331726/ /pubmed/32616894 http://dx.doi.org/10.1038/s41598-020-67891-w Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Al-Mouqdad, Mountasser M.
Khalil, Thanaa M.
Asfour, Suzan S.
Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title_full Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title_fullStr Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title_full_unstemmed Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title_short Retrospective study of short-term complications associated with early morphine use in intubated premature infants
title_sort retrospective study of short-term complications associated with early morphine use in intubated premature infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331726/
https://www.ncbi.nlm.nih.gov/pubmed/32616894
http://dx.doi.org/10.1038/s41598-020-67891-w
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