{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:02:06Z","timestamp":1783465326388,"version":"3.55.0"},"reference-count":31,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T00:00:00Z","timestamp":1599523200000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1060733"],"award-info":[{"award-number":["1060733"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1081288"],"award-info":[{"award-number":["1081288"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["108702"],"award-info":[{"award-number":["108702"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1108714"],"award-info":[{"award-number":["1108714"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1141354"],"award-info":[{"award-number":["1141354"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1153176"],"award-info":[{"award-number":["1153176"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["546519"],"award-info":[{"award-number":["546519"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,7,28]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>It is unclear how newer methods of respiratory support for infants born extremely preterm (EP; 22\u201327 weeks gestation) have affected in-hospital sequelae. We aimed to determine changes in respiratory support, survival and morbidity in EP infants since the early 1990s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The State of Victoria, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All EP births offered intensive care in four discrete eras (1991\u20131992 (24 months): n=332, 1997 (12 months): n=190, 2005 (12 months): n=229, and April 2016\u2013March 2017 (12 months): n=250).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Consumption of respiratory support, survival and morbidity to discharge home. Cost-effectiveness ratios describing the average additional days of respiratory support associated per additional survivor were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median duration of any respiratory support increased from 22 days (1991\u20131992) to 66 days (2016\u20132017). The increase occurred in non-invasive respiratory support (2 days (1991\u20131992) to 51 days (2016\u20132017)), with high-flow nasal cannulae, unavailable in earlier cohorts, comprising almost one-half of the duration in 2016\u20132017. Survival to discharge home increased (68% (1991\u20131992) to 87% (2016\u20132017)). Cystic periventricular leukomalacia decreased (6.3% (1991\u20131992) to 1.2% (2016\u20132017)), whereas retinopathy of prematurity requiring treatment increased (4.0% (1991\u20131992) to 10.0% (2016\u20132017)). The average additional costs associated with one additional infant surviving in 2016\u20132017 were 200 (95% CI 150 to 297) days, 326 (183 to 1127) days and 130 (70 to 267) days compared with 1991\u20131992, 1997 and 2005, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consumption of resources for respiratory support has escalated with improved survival over time. Cystic periventricular leukomalacia reduced in incidence but retinopathy of prematurity requiring treatment increased. How these changes translate into long-term respiratory or neurological function remains to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-037507","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T15:35:13Z","timestamp":1599752113000},"page":"e037507","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Changing consumption of resources for respiratory support and short-term outcomes in four consecutive geographical cohorts of infants born extremely preterm over 25 years since the early 1990s"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5901-0455","authenticated-orcid":false,"given":"Jeanie L Y","family":"Cheong","sequence":"first","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"},{"name":"Newborn Research, Royal Women\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy E","family":"Olsen","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"},{"name":"Newborn Research, Royal Women\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Huang","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M","family":"Dalziel","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemarie A","family":"Boland","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"},{"name":"Nursing, University of Melbourne, Parkville, Victoria, Australia"},{"name":"Paediatric Infant Perinatal Emergency Retrieval, , Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Safer Care Victoria, Victorian Department of Health and Human Services, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice C","family":"Burnett","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Parkville, Victoria, Australia"},{"name":"Newborn Research, Royal Women\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Department of Neonatal Medicine, Royal Children\u2019s Hospital, Melbourne, Victoria, 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