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Early prediction of nasal continuous positive airway pressure failure in preterm infants less than 30 weeks gestation
Author(s) -
De Jaegere Anne P,
van der Lee Johanna H,
Canté Caroline,
van Kaam Anton H
Publication year - 2012
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2011.02558.x
Subject(s) - medicine , continuous positive airway pressure , gestation , fraction of inspired oxygen , logistic regression , gestational age , airway , birth weight , pediatrics , anesthesia , pregnancy , mechanical ventilation , biology , obstructive sleep apnea , genetics
Aim: To predict early nasal continuous positive airway pressure failure within the first 2 h after birth in preterm infants. Methods: Patient and respiratory support variables significantly associated with continuous positive airway pressure failure in the first 72 h after birth were identified in a cohort of preterm infants <30 weeks gestation. Using multivariable logistic regression analysis, risk estimates for early nasal continuous positive airway pressure failure were calculated. Results: From 182 infants included, 62(34%) failed early nasal continuous positive airway pressure. Birth weight ≤800 g, male gender and a fraction of inspired oxygen >0.25 at 1 and 2 h of age were significantly associated with early nasal continuous positive airway pressure failure. Combining these variables in a logistic regression model provided a minimal risk estimate for failure of 0.04[0.01–0.23] (female >800 g, FiO 2 ≤ 0.25 at 1, and 2 h) and maximal estimate of 0.92[0.44–0.99] (male ≤800 g, FiO 2 > 0.25 at 1 and 2 h). Conclusion: Combining gender, birth weight and the fraction of inspired oxygen at 1 and 2 h of age allows for a better and more individualized prediction of early nasal continuous positive airway pressure failure in preterm infants less than 30 weeks gestation.