Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Parkland Health and Hospital System, Dallas, TX, USA.
J Perinatol. 2019 Aug;39(8):1081-1088. doi: 10.1038/s41372-019-0392-z. Epub 2019 May 14.
To develop a prediction model to identify infants admitted on continuous positive airway pressure (CPAP) requiring intubation within seventy-two hours of life (HOL).
Infants born ≤29 weeks' gestational age between 2013 and April 2018 were randomly assigned to either a modeling cohort (MC) or a validation cohort (VC) in a 2:1 ratio. Variables available within two HOL were compared between the CPAP failure group (CFG) and the CPAP success group (CSG).
Of the 189 infants in the MC, 50% failed CPAP. Compared to CSG, infants in the CFG had lower antenatal steroid exposure, birth weight, higher radiographic severe respiratory distress syndrome (RDS) and fraction of inspired oxygen (FiO). A forward stepwise logistic regression modeling in both MC and VC showed that FiO >0.3 and radiographic severe RDS predicted CPAP failure.
FiO >0.3 within two HOL and radiographic severe RDS predicts CPAP failure in preterm infants.
建立一种预测模型，以识别出生后 72 小时内需要气管插管的持续气道正压通气（CPAP）治疗的婴儿。
2013 年至 2018 年 4 月，将出生时胎龄≤29 周的婴儿按 2:1 的比例随机分配到建模队列（MC）或验证队列（VC）中。比较 CPAP 失败组（CFG）和 CPAP 成功组（CSG）在 2 个 HOL 内可用的变量。
在 MC 中的 189 名婴儿中，有 50%的婴儿 CPAP 治疗失败。与 CSG 相比，CFG 中的婴儿产前皮质激素暴露、出生体重较低，放射性严重呼吸窘迫综合征（RDS）和吸入氧分数（FiO）较高。在 MC 和 VC 中进行的向前逐步逻辑回归模型显示，FiO＞0.3 和放射性严重 RDS 预测 CPAP 失败。
出生后 2 小时内 FiO＞0.3 和放射性严重 RDS 可预测早产儿 CPAP 治疗失败。
