Document Detail


Risk factors of the failure of surfactant treatment by transient intubation during nasal continuous positive airway pressure in preterm infants.
MedLine Citation:
PMID:  18841536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to identify risk factors and neonatal outcomes associated with the failure of the INSURE method ( INtubation- SURfactant- Extubation) during nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome. We used a retrospective analysis of the prenatal histories, clinical courses, and laboratory data of all inborn infants with gestational age 27 to 34 weeks and respiratory distress syndrome treated with INSURE method. Infants were categorized into two groups: INSURE failure group and INSURE success group. One hundred nine infants were eligible to the study. INSURE failure was registered in 35 infants (32.1%). After control for confounding variables, INSURE failure was significantly associated with arterial partial pressure of carbon dioxide (adjusted odds ratio [OR] = 1.82; 95% confidence interval [CI] = 1.76 to 90.56), mean arterial-to-alveolar oxygen tension ratio (adjusted OR = 1.13; 95% CI = 1.06 to 85.34) and severe radiological grade (adjusted OR = 1.31; 95% CI = 1.15 to 70.16). Positive predictive values of these variables were 70, 75, and 55%, respectively. Patent ductus arteriosus and mortality rates were significantly higher in INSURE failure group. Arterial partial pressure of carbon dioxide, arterial-to-alveolar oxygen tension ratio, and severe radiological grade are predictors of the failure of INSURE method in preterm infants with respiratory distress syndrome. However, a prospective randomized controlled trial is needed to determine whether or not infants at risk for INSURE failure are better off being treated with mechanical ventilation.
Authors:
Ahmed Cherif; Chadlia Hachani; Naima Khrouf
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Publication Detail:
Type:  Journal Article     Date:  2008-10-07
Journal Detail:
Title:  American journal of perinatology     Volume:  25     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-28     Completed Date:  2009-01-26     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  647-52     Citation Subset:  IM    
Affiliation:
Neonatal Intensive Care Unit, Neonatology and Maternity Center, Faculty of Medicine, Department of Neonatology, University of Tunis, Tunis, Tunisia. ahmedcherif@voila.fr
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MeSH Terms
Descriptor/Qualifier:
Biological Agents / therapeutic use*
Carbon Dioxide / blood
Continuous Positive Airway Pressure*
Ductus Arteriosus, Patent / epidemiology
Humans
Infant Mortality
Infant, Newborn
Infant, Premature
Lung / radiography
Oxygen / blood
Phospholipids / therapeutic use*
Predictive Value of Tests
Pulmonary Surfactants / therapeutic use*
Respiratory Distress Syndrome, Newborn / radiography,  therapy*
Retrospective Studies
Risk Factors
Severity of Illness Index
Treatment Failure
Chemical
Reg. No./Substance:
0/Biological Agents; 0/Phospholipids; 0/Pulmonary Surfactants; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen; KE3U2023NP/poractant alfa

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