Department of Neonatology Emma Children's Hospital AMC, Amsterdam, The Netherlands.
Acta Paediatr. 2012 Apr;101(4):374-9. doi: 10.1111/j.1651-2227.2011.02558.x. Epub 2012 Jan 9.
To predict early nasal continuous positive airway pressure failure within the first 2 h after birth in preterm infants.
Patient and respiratory support variables significantly associated with continuous positive airway pressure failure in the first 72 h after birth were identified in a cohort of preterm infants <30 weeks gestation. Using multivariable logistic regression analysis, risk estimates for early nasal continuous positive airway pressure failure were calculated.
From 182 infants included, 62(34%) failed early nasal continuous positive airway pressure. Birth weight ≤800 g, male gender and a fraction of inspired oxygen >0.25 at 1 and 2 h of age were significantly associated with early nasal continuous positive airway pressure failure. Combining these variables in a logistic regression model provided a minimal risk estimate for failure of 0.04[0.01-0.23] (female >800 g, FiO(2) ≤ 0.25 at 1, and 2 h) and maximal estimate of 0.92[0.44-0.99] (male ≤800 g, FiO(2) > 0.25 at 1 and 2 h).
Combining gender, birth weight and the fraction of inspired oxygen at 1 and 2 h of age allows for a better and more individualized prediction of early nasal continuous positive airway pressure failure in preterm infants less than 30 weeks gestation.
预测早产儿生后 2 h 内早期经鼻持续气道正压通气失败。
在一项胎龄<30 周的早产儿队列中，确定了与生后 72 h 内持续气道正压通气失败显著相关的患者和呼吸支持变量。使用多变量逻辑回归分析，计算早期经鼻持续气道正压通气失败的风险估计值。
在 182 例婴儿中，62 例（34%）早期经鼻持续气道正压通气失败。出生体重≤800 g、男性和出生后 1、2 h 的吸入氧分数（FiO₂）>0.25 与早期经鼻持续气道正压通气失败显著相关。将这些变量结合在逻辑回归模型中，失败的最小风险估计值为 0.04[0.01-0.23]（女性>800 g，FiO₂≤0.25，1、2 h）和最大估计值为 0.92[0.44-0.99]（男性≤800 g，FiO₂>0.25，1、2 h）。
结合性别、出生体重和出生后 1、2 h 的吸入氧分数，可以更好地个体化预测胎龄<30 周的早产儿早期经鼻持续气道正压通气失败。
