{"doi":"10.3233/npm-230084","title":"Clinical impact of analgesic-sedative agents and peri-operative clinical status on white matter brain injury in preterm infants following surgical NEC","abstract":"BACKGROUND: The potential influence of exposure to analgesic-sedative agents (ASA) before, during, and after surgical NEC and peri-operative clinical status on white matter injury (WMI) in preterm infants has not been fully defined, and a comprehensive evaluation may inform future research and clinical interventions. METHODS: A retrospective study comparing ASA exposure before/during /after surgical NEC and peri-operative clinical status in neonates with and without WMI. RESULTS: Infants with any WMI (grade 2-4, n = 36/67, 53.7%) had a higher number of surgical procedures receiving ASA (5 [IQR: 3, 8] vs. 3 [2, 4]; p = 0.002) and had a longer duration of hypotension during their first (48.0 hours [26.0, 48.0] vs. 15.5 [6, 48]; p = 0.009) and second surgery (20 hours [0, 48h] vs. 0 [0, 22]; p = 0.017), received more hydrocortisone (35% vs.13.3%,p = 0.04) than those without any WMI. There were no differences in fentanyl/morphine/midazolam exposure before/during/after the NEC onset in the two groups.Infants with severe WMI (19/67, 28.3%, grade 3/4) had a higher incidence of AKI (P = 0.004), surgical morbidity (p = 0.047), more surgical procedures (6.5 [3, 10] vs. 4 [2, 5]; p = 0.012), and received higher mean fentanyl doses(p = 0.03) from birth until NEC onset than those without severe WMI. The univariate associations between these factors and severe WMI remained insignificant after multivariable logistic regression. CONCLUSION: Infants with WMI had more surgical procedures receiving ASA and had a longer duration of hypotension during surgeries. A large multicenter prospective study is needed to understand the full impact of ASA.","journal":"Journal of Neonatal-Perinatal Medicine","year":2023,"id":373483,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8978,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1134359,"name":"Andrew Rebentisch","orcid":"0009-0008-4693-5182","position":1,"is_corresponding":false},{"id":578460,"name":"M. Zhang","orcid":"0000-0003-3005-2189","position":2,"is_corresponding":false},{"id":920282,"name":"Jennifer Ware","orcid":null,"position":3,"is_corresponding":false},{"id":1134798,"name":"Melissa Pippins","orcid":null,"position":4,"is_corresponding":false},{"id":1113371,"name":"Charlotte Taylor","orcid":"0000-0002-7589-4040","position":5,"is_corresponding":false},{"id":1113372,"name":"Kartik Reddy","orcid":"0000-0001-7435-1864","position":6,"is_corresponding":false},{"id":479497,"name":"Tristan H. Lewis","orcid":"0000-0001-9697-5045","position":7,"is_corresponding":false},{"id":307371,"name":"Terrie E. Inder","orcid":"0000-0002-6012-9944","position":8,"is_corresponding":false},{"id":49897,"name":"William B. Hillegass","orcid":"0000-0001-6428-0564","position":9,"is_corresponding":false},{"id":400551,"name":"Parvesh Mohan Garg","orcid":"0000-0001-5949-7304","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T01:16:02.217046Z","pmid":"37742664","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}