The consequences of failing elective noninvasive respiratory support as compared to immediate intubation: a population study of very low birth weight neonates

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21460%2F15%3A00325728" target="_blank" >RIV/68407700:21460/15:00325728 - isvavai.cz</a>

Výsledek na webu

<a href="http://www.medwiekurozwoj.pl/articles/2015-3-1-2.pdf" target="_blank" >http://www.medwiekurozwoj.pl/articles/2015-3-1-2.pdf</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

The consequences of failing elective noninvasive respiratory support as compared to immediate intubation: a population study of very low birth weight neonates

Popis výsledku v původním jazyce

INTRODUCTION: Elective noninvasive respiratory support has become common. However, many neonates fail this procedure and they may require intubation. The aim of this study was to determine the relative outcome of very low birth weight neonates who failed noninvasive respiratory support compared to those that were initially intubated and mechanically ventilated. MATERIAL AND METHODS: We accessed the database of every neonate who received respiratory support in 18 hospitals in the central region of Poland and examined the records for a 7-year period. The evaluation encompassed 1667 neonates with very low birth weight who were potential candidates for elective noninvasive respiratory support. Three prospective primary outcome measures were assessed using logistic regression to control for differences in baseline risk. We also examined the length of respiratory support corrected for EGA. RESULTS: After controlling for significant baseline factors, we found that there was no statistically significant difference in mortality, severe retinopathy of prematurity (ROP) orsevere bronchopulmonary dysplasia (BPD) between infants failing noninvasive respiratory support and those electively intubated. However, their mortality and severe ROP were significantly higher than in those successfully treated with noninvasive respiratory support. Additionally, there was no difference in the length of mechanical ventilation or the length of all respiratory support between those that failed noninvasive support and those that were electively intubated. CONCLUSION: Our study suggests that in those preterm infants who are at a higher risk of failing noninvasive ventilation there is no compelling reason to administer elective intubation and mechanical ventilation immediately after birth. It seems that efforts should rather be made towards the implementation of the optimal non-invasive respiratory support.

Název v anglickém jazyce

The consequences of failing elective noninvasive respiratory support as compared to immediate intubation: a population study of very low birth weight neonates

Popis výsledku anglicky

INTRODUCTION: Elective noninvasive respiratory support has become common. However, many neonates fail this procedure and they may require intubation. The aim of this study was to determine the relative outcome of very low birth weight neonates who failed noninvasive respiratory support compared to those that were initially intubated and mechanically ventilated. MATERIAL AND METHODS: We accessed the database of every neonate who received respiratory support in 18 hospitals in the central region of Poland and examined the records for a 7-year period. The evaluation encompassed 1667 neonates with very low birth weight who were potential candidates for elective noninvasive respiratory support. Three prospective primary outcome measures were assessed using logistic regression to control for differences in baseline risk. We also examined the length of respiratory support corrected for EGA. RESULTS: After controlling for significant baseline factors, we found that there was no statistically significant difference in mortality, severe retinopathy of prematurity (ROP) orsevere bronchopulmonary dysplasia (BPD) between infants failing noninvasive respiratory support and those electively intubated. However, their mortality and severe ROP were significantly higher than in those successfully treated with noninvasive respiratory support. Additionally, there was no difference in the length of mechanical ventilation or the length of all respiratory support between those that failed noninvasive support and those that were electively intubated. CONCLUSION: Our study suggests that in those preterm infants who are at a higher risk of failing noninvasive ventilation there is no compelling reason to administer elective intubation and mechanical ventilation immediately after birth. It seems that efforts should rather be made towards the implementation of the optimal non-invasive respiratory support.

Druh

J_SC - Článek v periodiku v databázi SCOPUS

CEP obor

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OECD FORD obor

20601 - Medical engineering

Projekt

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Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2015

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Developmental Period Medicine

ISSN

1428-345X

e-ISSN

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Svazek periodika

319

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

PL - Polská republika

Počet stran výsledku

9

Strana od-do

254-262

Kód UT WoS článku

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EID výsledku v databázi Scopus

2-s2.0-84973410967