Early prediction of nasal continuous positive airway pressure failure in preterm infants less than 30 weeks gestation

Acta Paediatr. 2012 Apr;101(4):374-9. doi: 10.1111/j.1651-2227.2011.02558.x. Epub 2012 Jan 9.

Abstract

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.

MeSH terms

  • Cohort Studies
  • Continuous Positive Airway Pressure*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Risk Assessment / methods
  • Risk Factors
  • Time Factors
  • Treatment Failure