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Clinical Prediction Score for Nasal CPAP Failure in Pre-term VLBW Neonates with Early Onset Respiratory Distress.
MedLine Citation:
PMID:  20558382     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We prospectively observed 62 pre-term very low birth weight neonates initiated on nasal continuous positive airway pressure (CPAP) for respiratory distress in the first 24 h of life to devise a clinical score for predicting its failure. CPAP was administered using short binasal prongs with conventional ventilators. On multivariate analysis, we found three variables-gestation <28 weeks [adjusted odds ratio (OR) 6.5; 95% confidence interval (CI) 1.5-28.3], pre-term premature rupture of membranes [adjusted OR 5.3; CI 1.2-24.5], and product of CPAP pressure and fraction of inspired oxygen ≥1.28 at initiation to maintain saturation between 88% and 93% [adjusted OR 3.9; CI 1.0-15.5] to be independently predictive of failure. A prediction model was devised using weighted scores of these three variables and lack of exposure to antenatal steroids. The clinical scoring system thus developed had 75% sensitivity and 70% specificity for prediction of CPAP failure (area under curve: 0.83; 95% CI 0.71-0.94).
Authors:
Mrinal S Pillai; Mari J Sankar; Kalaivani Mani; Ramesh Agarwal; Vinod K Paul; Ashok K Deorari
Publication Detail:
Type:  Journal Article     Date:  2010-06-16
Journal Detail:
Title:  Journal of tropical pediatrics     Volume:  57     ISSN:  1465-3664     ISO Abbreviation:  J. Trop. Pediatr.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8010948     Medline TA:  J Trop Pediatr     Country:  England    
Other Details:
Languages:  eng     Pagination:  274-9     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
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