Li Ting, Jiang Hong, Liu Dong-Yun, Li Xiang-Hong
Department of Neonatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jun;16(6):610-3.
To study the risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome (RDS).
Seventy-one very preterm infants with RDS treated with InSure method were enrolled. These infants were categorized into two groups: InSure success (42 cases) and InSure failure (29 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for InSure failure.
The failure rate of the InSure method was 41%. The failure group were much lower in the birth weight, the antenatal steroids utilization rate and the vaginal delivery rate than the success group (P<0.05). The incidence of patent ductus arteriosus in the failure group was significantly higher than in the success group (P<0.05). PaO2, PaO2/FiO2 and PaO2/PAO2 in the failure group were significantly lower than in the success group (P<0.05). PaCO2 in the failure group was much higher than in the success group (P<0.05). Further logistic regression analysis showed that birth weight <1 150 g (OR=22.240 95%CI=2.124-232.901), PaCO2>54 mm Hg(OR=9.360, 95%CI=1.958-44.741, and PaO2/FiO2 <195 (OR=6.570, 95%CI=1.027-42.003), were the independmend risk factors for InSure failure. Furthermore, the duration of oxygen therapy, the total time of hospitalization and the incidence of BPD in the failure group were much longer and higher than in the success group (P<0.05).
Low birth weight, elevated PaCO2 and low PaO2/PiO2 ratio are the risk factors for the failure of the InSure method in very preterm infants.
研究因舒法（InSure）用于极早产儿呼吸窘迫综合征（RDS）失败的危险因素。
纳入71例采用因舒法治疗的极早产儿RDS患儿。这些患儿被分为两组：因舒法成功组（42例）和因舒法失败组（29例）。比较两组患儿的基本信息差异，并采用logistic回归分析确定因舒法失败的危险因素。
因舒法的失败率为41%。失败组患儿的出生体重、产前类固醇使用率和阴道分娩率均显著低于成功组（P<0.05）。失败组动脉导管未闭的发生率显著高于成功组（P<0.05）。失败组的动脉血氧分压（PaO2）、氧合指数（PaO2/FiO2）和肺泡动脉氧分压差（PaO2/PAO2）均显著低于成功组（P<0.05）。失败组的动脉血二氧化碳分压（PaCO2）显著高于成功组（P<0.05）。进一步的logistic回归分析显示，出生体重<1150 g（比值比[OR]=22.240，95%置信区间[CI]=2.124-232.901）、PaCO2>54 mmHg（OR=9.360，95%CI=1.958-44.741）以及PaO2/FiO2<195（OR=6.570，95%CI=1.027-42.003）是因舒法失败的独立危险因素。此外，失败组的氧疗时间、总住院时间和支气管肺发育不良（BPD）的发生率均显著长于和高于成功组（P<0.05）。
低出生体重、高PaCO2和低PaO2/FiO2比值是极早产儿因舒法失败的危险因素。
