Document Detail

Factors affecting nasal intermittent positive pressure ventilation failure and impact on bronchopulmonary dysplasia in neonates.
MedLine Citation:
PMID:  24875408     Owner:  NLM     Status:  Publisher    
Background:Nasal intermittent positive pressure ventilation (NIPPV) is becoming more important as a mode of ventilation in premature neonates predisposed to development of bronchopulmonary dysplasia (BPD). To the best of our knowledge, there have been no detailed studies characterizing neonates who fail NIPPV.Objective:To determine the differences between neonates who are successfully extubated to NIPPV and those who require re-intubation from NIPPV, and the impact of timing of NIPPV failure on BPD rates.Study Design:This was a retrospective cohort study in which we included infants with gestational age (GA) ⩽28 weeks and birth weight ⩽1000 g. χ(2)-test, analysis of variance and multivariate logistic regression models were used.Results:Two hundred and forty infants were studied; 180 failed NIPPV and of those, 33 (18%), 39 (22%) and 108 (60%) failed NIPPV within 0 to 6 h, ⩾6 to 24 h and ⩾24 h, respectively. Female sex and increased weight were protective against NIPPV failure (adjusted odds ratio (95% confidence interval): 0.28 (0.14 to 0.58), 0.04 (0.01 to 0.22)). Increased GA at extubation and female sex were both associated with increased time to failure (P=0.008, <0.001, respectively). Apnea was more likely the cause for failure ⩾24 h (P=0.015), whereas increased work of breathing/fraction of inspired oxygen requirements were more significant when NIPPV failure occurred earlier (P=0.001). Neonates who failed NIPPV within 24 h did not have any association with likelihood of developing BPD or severity of BPD, after adjusting for confounding variables.Conclusion:Significant differences in neonatal characteristics may help identify which neonates are more likely to fail NIPPV, and their timing of failure.Journal of Perinatology advance online publication, 29 May 2014; doi:10.1038/jp.2014.100.
P Mehta; J Berger; E Bucholz; V Bhandari
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-29
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  -     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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