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Outcomes of preterm infants receiving positive pressure support at term corrected gestation
Author(s) -
McMorrow Aoife,
Smirk Cameron,
Davis Peter G,
Fox Lisa M
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12401
Subject(s) - medicine , gestation , term (time) , obstetrics , pediatrics , pregnancy , genetics , biology , physics , quantum mechanics
Aim To establish the mortality rate to hospital discharge of very preterm infants who remain on positive pressure support (PPS) at term corrected gestation and describe factors that are associated with increased mortality. Methods Infants born <30 weeks' gestation between 1 J anuary 2001 and 31 D ecember 2009 who were receiving PPS at 40 weeks' postmenstrual age ( PMA ) were identified from our database, and their medical records reviewed. The fraction of inspired oxygen ( FiO 2 ), mean airway pressure and partial pressure of carbon dioxide ( PaCO 2 ) at 40 weeks' PMA were recorded. Receiver operating characteristic curves for mortality before discharge were generated. Results One thousand three hundred fifty‐nine of 1572 infants survived to term. Forty‐nine infants were receiving PPS at 40 weeks' PMA . Of these, 15 (31%) infants died before hospital discharge. All three infants who were ventilated via an endotracheal tube died. Increased oxygen requirement at term was associated with increased risk of death before discharge (area under curve ( AUC ) 0.75). FiO 2 > 0.5 was associated with an 80% risk of death. PaCO 2 was not predictive of death ( AUC 0.49). Conclusions Two thirds of very preterm infants who remained on PPS at 40 weeks' PMA survived to hospital discharge. Risk of death rises with increasing oxygen requirements. All five infants with FiO 2 > 0.70 died.