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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

Journal of Perinatology volume 35, pages 99–103 (2015)Cite this article

Subjects

Abstract

Objective:

To determine whether early radiologic evidence of severe respiratory distress syndrome (RDS) is predictive of nasal continuous positive airway pressure (CPAP) failure in extremely low birth weight (ELBW) infants during the first 72 h of age.

Study design:

Retrospective analysis of 235 consecutively inborn ELBW infants who received initial support with CPAP. CPAP success (n=151) and CPAP failure (n=84) groups were designated according to outcome within the first 72 h of age. We assessed the ability of radiologic evidence of severe RDS in the initial chest radiograph, alone and in combination with other variables available in the first hours of life, to predict CPAP failure.

Result:

Severe RDS had a positive predictive value (PPV) of 0.81 (95% confidence interval (CI) 0.64, 0.92) for CPAP failure. The combination of severe RDS and gestational age (GA)⩽26 weeks had a PPV of 0.92 (95% CI 0.68, 0.96).

Conclusion:

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

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA,

    T Tagliaferro, D Bateman & R A Polin

  2. Division of Pediatric Radiology, Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA,

    C Ruzal-Shapiro

Authors
  1. T Tagliaferro
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  2. D Bateman
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  3. C Ruzal-Shapiro
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  4. R A Polin
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Corresponding author

Correspondence to R A Polin.

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Competing interests

No external funding was used to support the conduct of the study or manuscript preparation. The first draft was written by Thea Tagliaferro, MD. The authors declare no conflict of interest.

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Tagliaferro, T., Bateman, D., Ruzal-Shapiro, C. et al. Early radiologic evidence of severe respiratory distress syndrome as a predictor of nasal continuous positive airway pressure failure in extremely low birth weight newborns. J Perinatol 35, 99–103 (2015). https://doi.org/10.1038/jp.2014.164

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