Failure of early nasal continuous positive airway pressure in preterm infants of 26 to 30 weeks gestation

Abstract

The need for oxygen in resuscitation and maintained in first hours of life, male gender, a CPAP pressure over 5 cm H(2)O and surfactant need are predictors of ENCPAP failure in preterm neonates 26 to 30 weeks gestational age.

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

“…In a retrospective study, De Jaegere et al 15 found that BW o800 g and male gender combined with the fraction of inspired oxygen40.25 at 1 to 2 h of age were associated with early CPAP failure. In a prospective multicenter trial, Rocha et al 16 17 showed that, for preterm infants o32 weeks gestation, CPAP failure can be predicted by the highest FiO 2 in the first hours of life; they proposed using FiO 2 40.30 as the cutoff value for intubation and surfactant administration. The authors also showed that most infants failing CPAP had moderate-to-severe RDS on a chest radiograph, but the radiological severity of RDS was not used as a predictor for failure.…”

Outcome of very-low-birth-weight babies managed with nasal continuous positive airway pressure, with or without surfactant, in a high-care nursery

“…[10,11] Factors that have been found to be associated with CPAP failure have included lower gestational age (GA) and birth weight, amount of supplemental oxygen, male gender, FiO2/PaO2 ratio, PaCO2, pH and presence of apnoeas. [11,12] These factors indirectly reflect on the maturity of the infant and on the severity of the lung disease. A composite parameter that has been used to assess severity of illness in neonates is the clinical risk index for babies (CRIB) score.…”

Continuous Positive Airway Pressure to Prevent Neonatal Lung Injury: How Did We Get Here, and How Do We Improve?

“…53 Other groups have consistently demonstrated that male infants fail CPAP more often than female infants. 51,68,69 Not surprisingly, both an increasing oxygen requirement (>40%) in the first hours of life and an increasing CPAP requirement (>6 cm H 2 O) predict failure. 51,[68][69][70] However, as most units include these factors as criteria for intubation, this association is necessarily confounded as a predictor of failure.…”

“…51,68,69 Not surprisingly, both an increasing oxygen requirement (>40%) in the first hours of life and an increasing CPAP requirement (>6 cm H 2 O) predict failure. 51,[68][69][70] However, as most units include these factors as criteria for intubation, this association is necessarily confounded as a predictor of failure. A recent small study has shown that low tidal volume breaths, lower peak inspiratory flows, and increased oxygen requirement immediately after delivery can predict CPAP failure and deserves further study.…”