Predictors of Nasal Continuous Positive Airway Pressure Failure in Preterm Infants With Respiratory Distress Syndrome
,
Abstract
Respiratory support in infants with respiratory distress syndrome (RDS) plays an important role in the reduction of mortality and complications, but the treatment fails in some infants. This study aimed to identify the predictors of continuous positive airway pressure (CPAP) failure in preterm infants with RDS. This cross-sectional retrospective study was conducted on RDS-diagnosed preterm infants admitted to the neonatal intensive care unit of Fatemieh Hospital (Hamadan city) in 2021-2022. The infants were examined in terms of risk factors for CPAP failure. Data extracted from the medical records were recorded in a checklist and analyzed with SPSS version 21 software at a confidence level of 95%. CPAP failure was recorded in 37.6% of the studied 202 infants. The need for resuscitation at birth, low gestational age, low birth weight, multiple births, low 1-min and 5-min Apgar scores, the need for higher FIO2 and PEEP, acidosis, and the need for surfactant administration were significantly associated with CPAP failure. In logistic regression, low gestational age (OR 1.30, 95% CI: 1.082-1.576) and the need for resuscitation at birth (OR 0.426, 95% CI: 0.202-0.898) were the major predictors of CPAP failure. Lower gestational age and the need for PPV in the delivery room are good predictors of CPAP failure in preterm infants with RDS, who receive nasal CPAP as primary respiratory support.
2. Dargaville PA, Aiyappan A, De Paoli AG, Dalton RGB, Kuschel CA, Kamlin CO, et al. Continuous positive airway pressure failure in preterm infants: incidence, predictors and consequences. Neonatology 2013;104:8-14.
3. Dargaville PA, Gerber A, Johansson S, De Paoli AG, Kamlin CO, Orsini F, et al. Incidence and outcome of CPAP failure in preterm infants. Pediatrics 2016;138:e20153985.
4. De Jaegere AP, van der Lee JH, Cante C, van Kaam AH. Early prediction of nasal continuous positive airway pressure failure in preterm infants less than 30 weeks gestation. Acta Paediatr 2012;101:374-9.
5. Pillai MS, Sankar MJ, Mani K, Agarwal R, Paul VK, Deorari AK. Clinical prediction score for nasal CPAP failure in preterm VLBW neonates with early onset respiratory distress. J Trop Pediatr 2011;57:274-9.
6. Nyondo-Mipando AL, Woo Kinshella ML, Bohne C, Suwedi-Kapesa LC, Salimu S, Banda M, et al. Barriers and enablers of implementing bubble continuous positive airway pressure (CPAP): perspectives of health professionals in Malawi. PLoS One 2020;15:e0228915.
7. Ammari A, Suri M, Milisavljevic V, Sahni R, Bateman D, Sanocka U, et al. Variables associated with the early failure of nasal CPAP in very low birth weight infants. J Pediatr 2005;147:341-7.
8. Fuchs H, Lindner W, Leiprecht A, Mendler MR, Hummler HD. Predictors of early nasal CPAP failure and effects of various intubation criteria on the rate of mechanical ventilation in preterm infants ofo29 weeks gestational age. Arch Dis Child Fetal Neonatal Ed 2011;96:F343-7.
9. Murki S, Kandraju H, Oleti T, Gaddam P. Predictors of CPAP Failure–10 years’ Data of Multiple Trials from a Single Center: A Retrospective Observational Study. Indian J Pediatr 2020;87:891-6.
10. Dobryanskyy DO, Menshykova AO, Salabay ZV, Detsyk OY. Neonatal Preterm Respiratory Care in Ukraine: An Observational Study of Outcomes in Relation to Timing and Methods of Surfactant Treatment. Am J Perinatol 2022;39:889-96.
11. Radicioni M, Leonardi A, Lanciotti L, Rinaldi VE, Bini V, Camerini PG. How to improve CPAP failure prediction in preterm infants with RDS: a pilot study. Eur J Pediatr 2021;180:709-16.
12. Kakkilaya V, Wagner S, Mangona KLM, Brown LS, Jubran I, He H, et al. Early predictors of continuous positive airway pressure failure in preterm neonates. J Perinatol 2019;39:1081-8.
13. Sunil B, Girish N, Bhuyan M. Outcome of preterm babies with respiratory distress syndrome on nasal CPAP. Int J Contemp Pediatr 2017;4:1206-9.
14. Arora V, Gediya SG, Jain R. Outcome of premature babies with RDS using bubble CPAP. Int J Contemp Pediatr 2017;4:939-42.
15. Sabry A, Bastawy R, Abdullatif D, Edris A, El-Baz M. Clinical Predictors for Outcome of Continuous Positive Airway Pressure in Respiratory Distress Syndrome in Preterms: Single Center Study. Pediatr Sci J 2023;3:1-11.
16. Afjeh SA, Sabzehei MK, Shariati MK, Shamshiri AR, Esmaili F. Evaluation of initial respiratory support strategies in VLBW Neonates with RDS. Arch Iran Med 2017;20:158-64.
17. Permatahati WI, Setyati A, Haksari EL. Predictor Factors of Continuous Positive Airway Pressure Failure in Preterm Infants with Respiratory Distress. Glob Pediatr Health 2021;8:2333794X211007464
18. Dell'Orto V, Nobile S, Correani A, Marchionni P, Giretti I, Rondina C, et al. Early nasal continuous positive airway pressure failure prediction in preterm infants less than 32 weeks gestational age suffering from respiratory distress syndrome. Pediatr Pulmonol 2021;56:3879-86
19. Sahussarungsi S, Techasatid W. Predictors of Early Nasal Continuous Positive Airway Pressure (CPAP) Failure and Consequences in Preterm Infants in Thammasat University Hospital. J Med Assoc Thai 2017;100:46-51.
20. Croop SEW, Thoyre SM, Aliaga S, McCaffrey MJ, Peter-Wohl S. The Golden Hour: a quality improvement initiative for extremely premature infants in the neonatal intensive care unit. J Perinatol 2020;40:530-9.
| Files | ||
| Issue | Vol 62 No 1 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v62i1.16884 | |
| Keywords | ||
| Preterm infants Respiratory distress syndrom Continuous positive airway pressure | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
