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  • Original Article
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Factors affecting outcomes in very low birth weight infants treated electively with nasal continuous positive airway pressure

Journal of Perinatology volume 30, pages 112–117 (2010)Cite this article

Abstract

Objective:

Although interest in nasal continuous positive airway pressure (nCPAP) to avoid intubation is increasing, there is limited data regarding patient selection and outcome. We sought to determine the baseline parameters associated with failure.

Study Design:

In all, 938 cases of elective nCPAP use were extracted from our registry. Two primary end points, Treatment Failure (need for intubation) and Bad Outcome (death, need for respiratory support at 40 weeks post conceptual age, grade 4 intraventricular hemorrhage or periventricular leucomalacia), and 12 potentially predictive baseline parameters were prospectively defined and evaluated using logistic regression.

Result:

Intubation occurred in 31%, and Bad Outcome occurred in 11%. Besides estimated gestational age (EGA), only a few variables were significant predictors in the multivariate models: Intubation (PaO2/FiO2<150 or pH< 7.25) and Bad Outcome (FiO2, low weight for EGA). The relative risk doubled between infants of 34 and 26 weeks EGA and increased by about 50% for those meeting the other criteria.

Conclusion:

We hope these findings will help those using elective nCPAP to refine their practice and those considering its use in establishing reasonable guidelines, as well as be useful for designing clinical research.

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Acknowledgements

We wish to recognize Professor Elsbieta Gajewska without whose vision and leadership the Neonatal Noninvasive Respiratory Study Group would not have been possible. We are also extremely grateful to Mr Jerzy Owsiak of The Great Orchestra of Christmas Foundation for generous support both to our research and to the 600 pediatric units in Poland.

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Authors and Affiliations

  1. Department of Anesthesiology & Intensive Care, The Children's Memorial Health Institute, Warsaw, Poland

    J Swietlinski

  2. Department of Business & Public Administration, California State University, San Bernardino, CA, USA

    T Bachman

  3. Department of Neonatology, Medical University, Wroclaw, Poland

    E Gajewska

  4. Department of Neonatology, Medical University of Silesia, Katowice, Poland

    K Bober

  5. Department of Neonatology, National Research Institute of Mother & Child, Warsaw, Poland

    E Helwich

  6. Department of Neonatology, Medical College Jagiellonian University, Cracow, Poland

    R Lauterbach

  7. Department of Neonatology, The Children's Memorial Health Institute, Warsaw, Poland

    B Maruszewski

  8. Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland

    J Szczapa

  9. Department of Biostatistics, Medical University of Silesia, Katowice, Poland

    M Skrzypek

Authors
  1. J Swietlinski
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  2. T Bachman
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  3. E Gajewska
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  4. K Bober
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  5. E Helwich
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  6. R Lauterbach
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  7. B Maruszewski
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  8. J Szczapa
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  9. M Skrzypek
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on behalf of the Polish Noninvasive Respiratory Study Group

Corresponding author

Correspondence to T Bachman.

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Swietlinski, J., Bachman, T., Gajewska, E. et al. Factors affecting outcomes in very low birth weight infants treated electively with nasal continuous positive airway pressure. J Perinatol 30, 112–117 (2010). https://doi.org/10.1038/jp.2009.135

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  • DOI: https://doi.org/10.1038/jp.2009.135

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