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

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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, FiO2 ≤ 0.25 at 1, and 2 h) and maximal estimate of 0.92[0.44–0.99] (male ≤800 g, FiO2 > 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.

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