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In-line filtration in very preterm neonates: a randomized controlled trial

Abstract : In-line filtration is increasingly used in critically-ill infants but its benefits, by preventing micro-particle infusion in very preterm neonates, remain to be demonstrated. We conducted a randomized controlled trial among very preterm infants allocated to receive either in-line filtration of all the intra-venous lines or standard care without filters. The primary outcome was differences greater than 20% in the median changes in pro-inflammatory cytokine serum concentrations measured at day 3 and day 8 (+/-1) using a Luminex multianalytic profiling technique. Major neonatal complications were analyzed as secondary predefined outcomes. We randomized 146 infants, assigned to filter (n = 73) or control (n = 73) group. Difference over 20% in pro-inflammatory cytokine concentration between day 3 and day 8 was not found statistically different between the two groups, both in intent-to-treat (with imputation) and per protocol (without imputation) analyses. The incidences of most of neonatal complications were found to be similar. Hence, this trial did not evidence a beneficial effect of in-line filtration in very preterm infants on the inflammatory response syndrome and neonatal morbidities. These data should be interpreted according to local standards in infusion preparation and central line management.
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Submitted on : Wednesday, April 8, 2020 - 12:16:44 PM
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Anne-Laure Virlouvet, Julien Pansiot, Artemis Toumazi, Marina Colella, Andreas Capewell, et al.. In-line filtration in very preterm neonates: a randomized controlled trial. Scientific Reports, Nature Publishing Group, 2020, 10 (1), pp.5003. ⟨10.1038/s41598-020-61815-4⟩. ⟨inserm-02536737⟩

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