Randomized Controlled Trial

. 2014 Aug;165(2):240-249.e4.

doi: 10.1016/j.jpeds.2014.02.054. Epub 2014 Apr 13.

Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT)

Timothy P Stevens¹, Neil N Finer², Waldemar A Carlo³, Peter G Szilagyi⁴, Dale L Phelps⁴, Michele C Walsh⁵, Marie G Gantz⁶, Abbot R Laptook⁷, Bradley A Yoder⁸, Roger G Faix⁸, Jamie E Newman⁶, Abhik Das⁹, Barbara T Do⁶, Kurt Schibler¹⁰, Wade Rich², Nancy S Newman⁵, Richard A Ehrenkranz¹¹, Myriam Peralta-Carcelen³, Betty R Vohr⁷, Deanne E Wilson-Costello⁵, Kimberly Yolton¹⁰, Roy J Heyne¹², Patricia W Evans¹³, Yvonne E Vaucher², Ira Adams-Chapman¹⁴, Elisabeth C McGowan¹⁵, Anna Bodnar⁸, Athina Pappas¹⁶, Susan R Hintz¹⁷, Michael J Acarregui¹⁸, Janell Fuller¹⁹, Ricki F Goldstein²⁰, Charles R Bauer²¹, T Michael O'Shea²², Gary J Myers⁴, Rosemary D Higgins²³; SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Collaborators, Affiliations

Collaborators

SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network:
Abhik Das, Marie Gantz, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Bonnie E Stephens, Barbara Alksninis, Dawn Andrews, Kristen Angela, Melinda Caskey, Kim Francis, Regina A Gargus, Dan Gingras, Katharine Johnson, Shabnam Lainwala, Suzy Ventura, Rachel V Walden, Avroy A Fanaroff, Bonnie S Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G Friedman, Gulgun Yalcinkaya, Edward F Donovan, Vivek Narendran, Kate Bridges, Barbara Alexander, Estelle E Fischer, Teresa L Gratton, Cathy Grisby, Jody Hessling, Lenora Jackson, Kristin Kirker, Holly L Mincey, Marcia Worley Mersmann, Ronald N Goldberg, Michael Cotten, Patricia Ashley, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sharon F Freedman, Kathryn E Gustafson, Melody B Lohmeyer, William F Malcolm, David K Wallace, Barbara J Stoll, Susie Buchter, Anthony J Piazza, David P Carlton, Ellen C Hale, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Leslie D Wilson, Faithe Hamer, Dianne E Herron, Carolyn Lytle, Heike M Minnich, Anna M Dusick, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, W Kenneth Poole, Betty K Hastings, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, James W Pickett 2nd, Dennis Wallace, Kristin M Zaterka-Baxter, Krisa P Van Meurs, David K Stevenson, Bethany Ball, Elizabeth F Bruno, Alexis S Davis, Maria Elena DeAnda, Anne M DeBattista, Lynne C Huffman, Jean G Kohn, Melinda S Proud, Nicholas H St John, Hali E Weiss, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Kirstin J Bailey, Fred J Biasini, Maria Hopkins, Kristen C Johnston, Sara Krzywanski, Kathleen G Nelson, Cryshelle S Patterson, Richard V Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, Maynard R Rasmussen, Paul R Wozniak, Kathy Arnell, Rene Barbieri-Welge, Ayala Ben-Tall, Renee Bridge, Clarence Demetrio, Martha G Fuller, Elaine Ito, Meghan Lukasik, Deborah Pontillo, Donna Posin, Cheryl Runyan, James Wilkes, Paul Zlotnik, Edward F Bell, John A Widness, Jonathan M Klein, Tarah T Colaizy, Karen J Johnson, Diane L Eastman, Shahnaz Duara, Ruth Everett-Thomas, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Elaine O Mathews, Helina Pierre, Arielle Riguard, Alexandra Stroerger, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Nirupama Laroia, Gary Myers, Gary David Markowitz, Linda J Reubens, Caryn Graff Havens, Diane Hust, Julie Babish Johnson, Erica Burnell, Rosemary L Jensen, Emily Kushner, Joan Merzbach, Kelley Yost, Lauren Zwetsch, Pablo J Sánchez, Charles R Rosenfeld, Walid A Salhab, Luc P Brion, Sally S Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T Heyne, Melissa H Lepps, Linda A Madden, Melissa Martin, Nancy A Miller, Janet S Morgan, Araceli Solis, Lizette E Torres, Catherine Twell Boatman, Diana M Vasil, Kerry Wilder, Kathleen A Kennedy, Jon E Tyson, Esther G Akpa, Nora I Alaniz, Susan E Dieterich, Patricia W Evans, Charles E Green, Beverly Foley Harris, Margarita Jiminez, Anna E Lis, Sara C Martin, Georgia E McDavid, Brenda H Morris, Layne Poundstone, Stacey Reddoch, Saba Khan Siddiki, Patti L Pierce Tate, Sharon L Wright, Shawna Baker, Karie Bird, Jill Burnett, Laura Cole, Karen A Osborne, Cynthia Spencer, Mike Steffens, Kimberlee Weaver-Lewis, Karen Zanetti, Robert G Dillard, Lisa K Washburn, Nancy J Peters, Barbara G Jackson, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Raquel Halfond, Carroll Peterson, Ellen L Waldrep, Cherrie D Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G Sood, Lilia DeJesus, Rebecca Bara, Elizabeth Billian, Laura A Goldston, Mary Johnson, Vineet Bhandari, Harris C Jacobs, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft, Christine G Butler, Nancy Close, Walter Gilliam, Sheila Greisman, Elaine Romano, Joanne Williams, Gordon Avery, Christine A Gleason, Marilee C Allen, Shrikant I Bangdiwala, Carol J Blaisdell, Robert J Boyle, Traci Clemons, Mary E D'Alton, Abhik Das, Dorothy B Gail, Carl Hunt, Martin Keszler, W Kenneth Poole, Carol K Redmond, Michael G Ross, Merran A Thomson, Steven J Weiner, Marian Willinger

Affiliations

¹ Department of Pediatrics, University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY. Electronic address: timothy_stevens@urmc.rochester.edu.
² Division of Neonatology, University of California at San Diego, San Diego, CA.
³ Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.
⁴ Department of Pediatrics, University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY.
⁵ Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH.
⁶ Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC.
⁷ Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI.
⁸ Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
⁹ Social, Statistical, and Environmental Sciences, RTI International, Rockville, MD.
¹⁰ Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH.
¹¹ Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
¹² Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
¹³ Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX.
¹⁴ Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA.
¹⁵ Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, MA.
¹⁶ Department of Pediatrics, Wayne State University, Detroit, MI.
¹⁷ Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
¹⁸ Department of Pediatrics, University of Iowa, Iowa City, IA.
¹⁹ Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, NM.
²⁰ Department of Pediatrics, Duke University, Durham, NC.
²¹ University of Miami Miller School of Medicine, Miami, FL.
²² Division of Neonatology, Wake Forest University School of Medicine, Winston-Salem, NC.
²³ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

PMID: 24725582
PMCID: PMC4111960
DOI: 10.1016/j.jpeds.2014.02.054

Randomized Controlled Trial

Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT)

Timothy P Stevens et al. J Pediatr. 2014 Aug.

. 2014 Aug;165(2):240-249.e4.

doi: 10.1016/j.jpeds.2014.02.054. Epub 2014 Apr 13.

Authors

Collaborators

SUPPORT Study Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network:
Abhik Das, Marie Gantz, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Bonnie E Stephens, Barbara Alksninis, Dawn Andrews, Kristen Angela, Melinda Caskey, Kim Francis, Regina A Gargus, Dan Gingras, Katharine Johnson, Shabnam Lainwala, Suzy Ventura, Rachel V Walden, Avroy A Fanaroff, Bonnie S Siner, Arlene Zadell, Julie DiFiore, Monika Bhola, Harriet G Friedman, Gulgun Yalcinkaya, Edward F Donovan, Vivek Narendran, Kate Bridges, Barbara Alexander, Estelle E Fischer, Teresa L Gratton, Cathy Grisby, Jody Hessling, Lenora Jackson, Kristin Kirker, Holly L Mincey, Marcia Worley Mersmann, Ronald N Goldberg, Michael Cotten, Patricia Ashley, Kathy J Auten, Kimberley A Fisher, Katherine A Foy, Sharon F Freedman, Kathryn E Gustafson, Melody B Lohmeyer, William F Malcolm, David K Wallace, Barbara J Stoll, Susie Buchter, Anthony J Piazza, David P Carlton, Ellen C Hale, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Leslie D Wilson, Faithe Hamer, Dianne E Herron, Carolyn Lytle, Heike M Minnich, Anna M Dusick, Mary Anne Berberich, Carol J Blaisdell, Dorothy B Gail, James P Kiley, W Kenneth Poole, Betty K Hastings, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, James W Pickett 2nd, Dennis Wallace, Kristin M Zaterka-Baxter, Krisa P Van Meurs, David K Stevenson, Bethany Ball, Elizabeth F Bruno, Alexis S Davis, Maria Elena DeAnda, Anne M DeBattista, Lynne C Huffman, Jean G Kohn, Melinda S Proud, Nicholas H St John, Hali E Weiss, Ivan D Frantz 3rd, John M Fiascone, Anne Furey, Brenda L MacKinnon, Ellen Nylen, Ana Brussa, Cecelia Sibley, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Vivien A Phillips, Kirstin J Bailey, Fred J Biasini, Maria Hopkins, Kristen C Johnston, Sara Krzywanski, Kathleen G Nelson, Cryshelle S Patterson, Richard V Rector, Leslie Rodriguez, Amanda Soong, Sally Whitley, Sheree York, Maynard R Rasmussen, Paul R Wozniak, Kathy Arnell, Rene Barbieri-Welge, Ayala Ben-Tall, Renee Bridge, Clarence Demetrio, Martha G Fuller, Elaine Ito, Meghan Lukasik, Deborah Pontillo, Donna Posin, Cheryl Runyan, James Wilkes, Paul Zlotnik, Edward F Bell, John A Widness, Jonathan M Klein, Tarah T Colaizy, Karen J Johnson, Diane L Eastman, Shahnaz Duara, Ruth Everett-Thomas, Maria Calejo, Alexis N Diaz, Silvia M Frade Eguaras, Andrea Garcia, Kasey Hamlin-Smith, Michelle Harwood Berkowits, Sylvia Hiriart-Fajardo, Elaine O Mathews, Helina Pierre, Arielle Riguard, Alexandra Stroerger, Kristi L Watterberg, Robin K Ohls, Julie Rohr, Conra Backstrom Lacy, Jean Lowe, Rebecca Montman, Nirupama Laroia, Gary Myers, Gary David Markowitz, Linda J Reubens, Caryn Graff Havens, Diane Hust, Julie Babish Johnson, Erica Burnell, Rosemary L Jensen, Emily Kushner, Joan Merzbach, Kelley Yost, Lauren Zwetsch, Pablo J Sánchez, Charles R Rosenfeld, Walid A Salhab, Luc P Brion, Sally S Adams, James Allen, Laura Grau, Alicia Guzman, Gaynelle Hensley, Elizabeth T Heyne, Melissa H Lepps, Linda A Madden, Melissa Martin, Nancy A Miller, Janet S Morgan, Araceli Solis, Lizette E Torres, Catherine Twell Boatman, Diana M Vasil, Kerry Wilder, Kathleen A Kennedy, Jon E Tyson, Esther G Akpa, Nora I Alaniz, Susan E Dieterich, Patricia W Evans, Charles E Green, Beverly Foley Harris, Margarita Jiminez, Anna E Lis, Sara C Martin, Georgia E McDavid, Brenda H Morris, Layne Poundstone, Stacey Reddoch, Saba Khan Siddiki, Patti L Pierce Tate, Sharon L Wright, Shawna Baker, Karie Bird, Jill Burnett, Laura Cole, Karen A Osborne, Cynthia Spencer, Mike Steffens, Kimberlee Weaver-Lewis, Karen Zanetti, Robert G Dillard, Lisa K Washburn, Nancy J Peters, Barbara G Jackson, Korinne Chiu, Deborah Evans Allred, Donald J Goldstein, Raquel Halfond, Carroll Peterson, Ellen L Waldrep, Cherrie D Welch, Melissa Whalen Morris, Gail Wiley Hounshell, Seetha Shankaran, Beena G Sood, Lilia DeJesus, Rebecca Bara, Elizabeth Billian, Laura A Goldston, Mary Johnson, Vineet Bhandari, Harris C Jacobs, Pat Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft, Christine G Butler, Nancy Close, Walter Gilliam, Sheila Greisman, Elaine Romano, Joanne Williams, Gordon Avery, Christine A Gleason, Marilee C Allen, Shrikant I Bangdiwala, Carol J Blaisdell, Robert J Boyle, Traci Clemons, Mary E D'Alton, Abhik Das, Dorothy B Gail, Carl Hunt, Martin Keszler, W Kenneth Poole, Carol K Redmond, Michael G Ross, Merran A Thomson, Steven J Weiner, Marian Willinger

Affiliations

¹ Department of Pediatrics, University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY. Electronic address: timothy_stevens@urmc.rochester.edu.
² Division of Neonatology, University of California at San Diego, San Diego, CA.
³ Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.
⁴ Department of Pediatrics, University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY.
⁵ Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH.
⁶ Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC.
⁷ Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI.
⁸ Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
⁹ Social, Statistical, and Environmental Sciences, RTI International, Rockville, MD.
¹⁰ Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH.
¹¹ Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
¹² Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX.
¹³ Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX.
¹⁴ Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA.
¹⁵ Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, MA.
¹⁶ Department of Pediatrics, Wayne State University, Detroit, MI.
¹⁷ Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.
¹⁸ Department of Pediatrics, University of Iowa, Iowa City, IA.
¹⁹ Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, NM.
²⁰ Department of Pediatrics, Duke University, Durham, NC.
²¹ University of Miami Miller School of Medicine, Miami, FL.
²² Division of Neonatology, Wake Forest University School of Medicine, Winston-Salem, NC.
²³ Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

PMID: 24725582
PMCID: PMC4111960
DOI: 10.1016/j.jpeds.2014.02.054

Abstract

Objective: To explore the early childhood pulmonary outcomes of infants who participated in the National Institute of Child Health and Human Development's Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial (SUPPORT), using a factorial design that randomized extremely preterm infants to lower vs higher oxygen saturation targets and delivery room continuous positive airway pressure (CPAP) vs intubation/surfactant.

Study design: The Breathing Outcomes Study, a prospective secondary study to the Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial, assessed respiratory morbidity at 6-month intervals from hospital discharge to 18-22 months corrected age (CA). Two prespecified primary outcomes-wheezing more than twice per week during the worst 2-week period and cough longer than 3 days without a cold-were compared for each randomized intervention.

Results: One or more interviews were completed for 918 of the 922 eligible infants. The incidences of wheezing and cough were 47.9% and 31.0%, respectively, and did not differ between the study arms of either randomized intervention. Infants randomized to lower vs higher oxygen saturation targets had a similar risk of death or respiratory morbidity (except for croup and treatment with oxygen or diuretics at home). Infants randomized to CPAP vs intubation/surfactant had fewer episodes of wheezing without a cold (28.9% vs 36.5%; P<.05), respiratory illnesses diagnosed by a doctor (47.7% vs 55.2%; P<.05), and physician or emergency room visits for breathing problems (68.0% vs 72.9%; P<.05) by 18-22 months CA.

Conclusion: Treatment with early CPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18-22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates.

Trial registration: ClinicalTrials.gov NCT00233324.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**Figure**
CONSORT diagram including follow up rates. * Follow-up Cohort

See this image and copyright information in PMC

Comment in

Long-term respiratory morbidity in preterm infants: is noninvasive support in the delivery room the solution?
Foglia EE, Kirpalani H, DeMauro SB. Foglia EE, et al. J Pediatr. 2014 Aug;165(2):222-5. doi: 10.1016/j.jpeds.2014.04.018. Epub 2014 May 17. J Pediatr. 2014. PMID: 24840755 No abstract available.

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Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT)

Collaborators

Affiliations

Respiratory outcomes of the surfactant positive pressure and oximetry randomized trial (SUPPORT)

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

Comment in

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Molecular Biology Databases