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Factors affecting nasal intermittent positive pressure ventilation failure and impact on bronchopulmonary dysplasia in neonates.
- Source :
-
Journal of Perinatology . Oct2014, Vol. 34 Issue 10, p754-760. 7p. - Publication Year :
- 2014
-
Abstract
- 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. χ2-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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BRONCHOPULMONARY dysplasia
*ACADEMIC medical centers
*ANALYSIS of variance
*BODY weight
*CHI-squared test
*CONFIDENCE intervals
*FISHER exact test
*GESTATIONAL age
*INTERMITTENT positive pressure breathing
*MEDICAL records
*MULTIVARIATE analysis
*RISK assessment
*SEX distribution
*LOGISTIC regression analysis
*RETROSPECTIVE studies
*SEVERITY of illness index
*MEDICAL equipment reliability
*DATA analysis software
*DESCRIPTIVE statistics
*ODDS ratio
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 07438346
- Volume :
- 34
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Journal of Perinatology
- Publication Type :
- Academic Journal
- Accession number :
- 98560798
- Full Text :
- https://doi.org/10.1038/jp.2014.100