Dargaville, PA and Gerber, A and Johansson, S and De Paoli, AG and Kamlin, COF and Orsini, F and Davis, PG, for the Australian and New Zealand Neonatal Network, Incidence and Outcome of CPAP Failure in Preterm Infants, Pediatrics (English Edition), 138, (1) Article e20153985. ISSN 0031-4005 (2016) [Refereed Article]
Copyright 2016 American Academy of Pediatrics
METHODS: Data from inborn preterm infants managed on CPAP from the outset were analyzed in 2 gestational age ranges (25-28 and 29-32 completed weeks). Outcomes after CPAP failure (need for intubation <72 hours) were compared with those succeeding on CPAP using adjusted odds ratios (AORs).
RESULTS: Within the cohort of 19 103 infants, 11 684 were initially managed on CPAP. Failure of CPAP occurred in 863 (43%) of 1989 infants commencing on CPAP at 25-28 weeks' gestation and 2061 (21%) of 9695 at 29-32 weeks. CPAP failure was associated with a substantially higher rate of pneumothorax, and a heightened risk of death, bronchopulmonary dysplasia (BPD) and other morbidities compared with those managed successfully on CPAP. The incidence of death or BPD was also increased: (25-28 weeks: 39% vs 20%, AOR 2.30, 99% confidence interval 1.71-3.10; 29-32 weeks: 12% vs 3.1%, AOR 3.62 [2.76-4.74]). The CPAP failure group had longer durations of respiratory support and hospitalization.
CONCLUSIONS: CPAP failure in preterm infants is associated with increased risk of mortality and major morbidities, including BPD. Strategies to promote successful CPAP application should be pursued vigorously.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Field:||Paediatrics not elsewhere classified|
|Objective Group:||Specific population health (excl. Indigenous health)|
|Objective Field:||Neonatal and child health|
|UTAS Author:||Dargaville, PA (Professor Peter Dargaville)|
|Web of Science® Times Cited:||97|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||1 View Download Statistics|
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