| Predicting the need for ventilation in term and near-term neonates. | |
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MedLine Citation:
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PMID: 15265184 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether the need for respiratory support can be predicted by oxygen requirement within the first 72 h in term and near-term infants. METHODS: To mimic the population of infants that would often be delivered outside a tertiary centre we studied a retrospective cohort of infants > or = 32 weeks requiring oxygen, divided into three groups: cot oxygen only, nasal continuous positive airway pressure (NCPAP) only, or intermittent positive pressure ventilation (IPPV). We recorded each infant's peak fraction of inspired oxygen (FiO2)--i.e. FiO2 in the first 72 h in the cot oxygen only group or maximum FiO2 prior to commencing the highest level of respiratory support. The peak FiO2 was used as a diagnostic test to predict any respiratory support or IPPV--sensitivity and specificity were calculated and receiver operating characteristic (ROC) curves plotted (FiO2 0.21-1.00) to identify the best balance point for prediction. RESULTS: The cohort included 592 infants: 516 cot oxygen only, 46 NCPAP only and 30 IPPV. The proportion ventilated increased with increasing peak FiO2--above 0.45 the proportion of infants ventilated exceeded 50%. To predict any respiratory support, the cut-point balancing sensitivity and specificity was a FiO2 > or = 0.35-58/136 required respiratory support (sensitivity = 0.76, specificity = 0.85, positive predictive value (PPV) = 43%, negative predictive value (NPV) = 96%). To predict IPPV the cut-point was a FiO2 > or = 0.5-28/47 treated with IPPV (sensitivity = 0.93, specificity = 0.97, PPV = 60%, NPV = 100%). CONCLUSION: The need for respiratory support can be predicted by oxygen requirement within the first 72 h in term and near-term infants with reasonable sensitivity and excellent specificity. |
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Authors:
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A Morosini; M W Davies |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of paediatrics and child health Volume: 40 ISSN: 1034-4810 ISO Abbreviation: J Paediatr Child Health Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-07-21 Completed Date: 2004-12-02 Revised Date: 2007-09-24 |
Medline Journal Info:
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Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: Australia |
Other Details:
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Languages: eng Pagination: 438-43 Citation Subset: IM |
Affiliation:
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Grantley Stable Neonatal Unit, Royal Women's Hospital, Brisbane, Queensland, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Gas Analysis Cohort Studies Continuous Positive Airway Pressure Humans Infant, Newborn Intermittent Positive-Pressure Ventilation Needs Assessment Oxygen / blood*, metabolism Respiration, Artificial / methods, utilization* Respiratory Distress Syndrome, Newborn / prevention & control* Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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