Early radiologic evidence of severe respiratory distress syndrome as a predictor of nasal continuous positive airway pressure failure in extremely low birth weight newborns

Tagliaferro, Thea; Bateman, David A.; Ruzal-Shapiro, Carrie; Polin, Richard A.

doi:10.1038/jp.2014.164

Cited by 26 publications

(38 citation statements)

References 17 publications

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“…Data from several hospital-based cohort studies strongly suggest that CPAP failure is primarily caused by untreated surfactant deficiency, and is associated with adverse outcomes, including increased risk of mortality as well as morbidities, including air leak, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH). [9][10][11][12][13][14] Reported studies of CPAP failure have involved relatively small cohorts of infants managed at 1 or 2 centers. [9][10][11][12][13][14] Examination of the effects of initial CPAP support and CPAP failure within largescale neonatal databases has been hampered by difficulty in identifying the exact sequence of respiratory management in early life within the reported data.…”

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confidence: 99%

“…[9][10][11][12][13][14] Reported studies of CPAP failure have involved relatively small cohorts of infants managed at 1 or 2 centers. [9][10][11][12][13][14] Examination of the effects of initial CPAP support and CPAP failure within largescale neonatal databases has been hampered by difficulty in identifying the exact sequence of respiratory management in early life within the reported data. 15 Populationbased data on the incidence of, and outcomes after, CPAP failure would give clarity on the magnitude of the problem, both overall and within gestation strata.…”

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confidence: 99%

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Incidence and Outcome of CPAP Failure in Preterm Infants

et al. 2016

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confidence: 99%

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confidence: 99%

Incidence and Outcome of CPAP Failure in Preterm Infants

et al. 2016

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“…NCPAP failure is associated with the need for invasive MV, development of BPD and death. No consensus exists regarding the criteria used to characterize NCPAP failure, which is variably defined in studies, and neonatal units may have different success rates based on how NCPAP is applied at the bedside . However, different success rates in neonatal units have been reported, based on their experience with NCPAP use .…”

Section: Discussionmentioning

confidence: 99%

“…No consensus exists regarding the criteria used to characterize NCPAP failure, which is variably defined in studies, and neonatal units may have different success rates based on how NCPAP is applied at the bedside. [25][26][27] However, different success rates in neonatal units have been reported, based on their experience with NCPAP use. 4,28 The failure criteria for noninvasive ventilation used in this study correspond to our historical NCPAP failure rate of 40% to 50% among VLBW infants and are very similar to those used in other studies.…”

Section: Discussionmentioning

confidence: 99%

Nasal continuous positive airway pressure (NCPAP) or noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) for preterm infants with respiratory distress after birth: A randomized controlled trial

Yagui

Meneses

Zólio

et al. 2019

Pediatric Pulmonology

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Objectives To compare rates of treatment failure between the use of nasal continuous positive airway pressure (NCPAP) and noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) in infants with respiratory distress after birth. Methods A randomized, unblinded, double‐center trial was conducted in infants with birth weights (BWs) less than or equal to 1500 g and respiratory distress receiving noninvasive respiratory support for less than or equal to 48 hours of life; some infants were initially treated with minimally invasive surfactant therapy as the standard of care. Primary outcome: need for endotracheal intubation with use of mechanical ventilation (MV) at less than or equal to 72 hours of life using prespecified failure criteria. Secondary outcomes: use of surfactant, duration of noninvasive support, duration of MV, bronchopulmonary dysplasia (BPD) and death. Results A total of 123 infants were included (NCPAP group = 64 and NIV‐NAVA group = 59). Population characteristics were similar between groups. No difference in the primary outcome was observed: NCPAP = 10 (15.6%) and NIV‐NAVA = 12 (20.3%), P = .65. Groups were also similar in the use of surfactant (19 vs 17), duration of noninvasive support (147 ± 181 hours vs 127 ± 137 hours), BPD incidence and death. However, duration of MV was significantly longer in NCPAP group (95.6 ± 45.8 hours vs 28.25 ± 34.1 hour), P = .01. Conclusion In infants with respiratory distress after birth, no differences in treatment failures were observed between NIV‐NAVA and NCPAP. These results require further evaluation in a larger study.

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“…Retrospective studies have reported on the usage of intubation and surfactant therapy in moderate to late preterm infants. [12][13][14] However, there are no clear guidelines regarding indications for endotracheal intubation in moderate to late preterm infants of 32-36 weeks gestation. Hence, we conducted a survey of neonatologists in Australia and New Zealand to understand the current practice of clinicians in this area.…”

Section: Introductionmentioning

confidence: 99%

A survey on criteria for intubation in moderate to late preterm infants with respiratory distress

Feng

Rao

Patole

2020

Pediatric Pulmonology

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Background: Majority of preterm infants do well with continuous positive airway pressure (CPAP) as the sole respiratory management; but some require endotracheal intubation and surfactant administration. While intubation is needed predominantly in extremely preterm infants (<28 weeks); some of the more mature preterm infants also require it. Currently, there are no clear guidelines regarding indications for endotracheal intubation in such infants. Aims: To understand the current practice regarding "criteria for intubation" in moderate to late preterm infants with respiratory distress. Methods: A survey of neonatologists in Australia New Zealand Neonatal Network (ANZNN) was conducted between April and June 2019. Results: At least one neonatologist each from 29 of the 30 tertiary ANZNN Neonatal Intensive Care Units (NICUs) responded to the survey. In total, 118/ 200 (59%) neonatologists responded. The most common criteria for intubation were CPAP = 8 cmH 2 O (61%), pH < 7.2 (55%), pCO 2 > 70 mmHg (48%), FiO 2 > 40% (40%), chest retractions (48%), more than two episodes of apnea requiring intervention (54%), and chest X-ray (CXR) showing moderate-severe hyaline membrane disease (HMD, 49%). Conclusion: While there were variations in practice, nearly 50% of the neonatologists shared a common threshold with regards to the CPAP level, FiO 2 , blood gas parameters, and clinical and radiological findings. The results of this survey will help in designing future randomized controlled trials (RCTs) on this subject.

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Early radiologic evidence of severe respiratory distress syndrome as a predictor of nasal continuous positive airway pressure failure in extremely low birth weight newborns

Abstract: Early radiologic evidence of severe RDS is predictive of CPAP failure, especially in infants with GA ⩽ 26 weeks.

Cited by 26 publications

References 17 publications

Incidence and Outcome of CPAP Failure in Preterm Infants

Incidence and Outcome of CPAP Failure in Preterm Infants

Nasal continuous positive airway pressure (NCPAP) or noninvasive neurally adjusted ventilatory assist (NIV‐NAVA) for preterm infants with respiratory distress after birth: A randomized controlled trial

A survey on criteria for intubation in moderate to late preterm infants with respiratory distress

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