Document Detail

Factors affecting outcomes in very low birth weight infants treated electively with nasal continuous positive airway pressure.
MedLine Citation:
PMID:  19741653     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Although interest in nasal continuous positive airway pressure (nCPAP) to avoid intubation is increasing, there is limited data regarding patient selection and outcome. We sought to determine the baseline parameters associated with failure. STUDY DESIGN: In all, 938 cases of elective nCPAP use were extracted from our registry. Two primary end points, Treatment Failure (need for intubation) and Bad Outcome (death, need for respiratory support at 40 weeks post conceptual age, grade 4 intraventricular hemorrhage or periventricular leucomalacia), and 12 potentially predictive baseline parameters were prospectively defined and evaluated using logistic regression. RESULT: Intubation occurred in 31%, and Bad Outcome occurred in 11%. Besides estimated gestational age (EGA), only a few variables were significant predictors in the multivariate models: Intubation (PaO(2)/FiO(2)<150 or pH< 7.25) and Bad Outcome (FiO(2), low weight for EGA). The relative risk doubled between infants of 34 and 26 weeks EGA and increased by about 50% for those meeting the other criteria. CONCLUSION: We hope these findings will help those using elective nCPAP to refine their practice and those considering its use in establishing reasonable guidelines, as well as be useful for designing clinical research.
J Swietlinski; T Bachman; E Gajewska; K Bober; E Helwich; R Lauterbach; B Maruszewski; J Szczapa; M Skrzypek;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-10
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  30     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  112-7     Citation Subset:  IM    
Department of Anesthesiology & Intensive Care, The Children's Memorial Health Institute, Warsaw, Poland.
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MeSH Terms
Blood Gas Analysis
Continuous Positive Airway Pressure / adverse effects*
Gestational Age
Infant, Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight*
Intubation, Intratracheal
Poland / epidemiology
Prospective Studies
Respiratory Distress Syndrome, Newborn / mortality,  therapy*
Risk Factors
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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