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Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study
BACKGROUND: For initial respiratory management, continuous positive airway pressure (CPAP) is increasingly used for preterm infants, especially for gestational age less than 32 weeks. However, neonatologists are concerned about the potential risks of CPAP support failure. OBJECTIVES: To examine the...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291106/ https://www.ncbi.nlm.nih.gov/pubmed/34431114 http://dx.doi.org/10.1111/ppe.12801 |
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author | Wang, Li Li, Jia‐hui Yu, Yong‐hui Huang, Lei Huang, Xiao‐yang Fan, Xiu‐fang Zhang, Xiao‐hui Zhang, Chun‐lei Liu, Qiang Sun, Ai‐rong Zhang, Yong‐feng Cao, Yang‐yang Xu, Ping Liu, Xiu‐xiang Wu, Jing‐cai Yang, Zhen‐ying Sun, Rong‐rong Ren, Xue‐yun Li, Jing Wan, Xiao‐li Qiu, Bing‐ping Niu, Shi‐ping Zhu, Ren‐xia Wang, Xiao‐kang Zhang, Yi‐hui Gao, Yan‐ling Deng, Li‐ping Shi, Jing Bi, Mei‐rong |
author_facet | Wang, Li Li, Jia‐hui Yu, Yong‐hui Huang, Lei Huang, Xiao‐yang Fan, Xiu‐fang Zhang, Xiao‐hui Zhang, Chun‐lei Liu, Qiang Sun, Ai‐rong Zhang, Yong‐feng Cao, Yang‐yang Xu, Ping Liu, Xiu‐xiang Wu, Jing‐cai Yang, Zhen‐ying Sun, Rong‐rong Ren, Xue‐yun Li, Jing Wan, Xiao‐li Qiu, Bing‐ping Niu, Shi‐ping Zhu, Ren‐xia Wang, Xiao‐kang Zhang, Yi‐hui Gao, Yan‐ling Deng, Li‐ping Shi, Jing Bi, Mei‐rong |
author_sort | Wang, Li |
collection | PubMed |
description | BACKGROUND: For initial respiratory management, continuous positive airway pressure (CPAP) is increasingly used for preterm infants, especially for gestational age less than 32 weeks. However, neonatologists are concerned about the potential risks of CPAP support failure. OBJECTIVES: To examine the association between different initial respiratory support modalities and the outcomes of preterm infants at <32 weeks of gestation across multiple neonatal intensive care units (NICU) in China. METHODS: This study was carried out over a period of 12 months in 2018. Unadjusted relative risks (RR) for demographic and clinical characteristics were calculated for CPAP failure and CPAP success in the total cohort using log‐linear model based on generalised estimating equations for clustered observations. RESULTS: Among 1560 preterm infants delivered at <32 weeks, the incidence of CPAP failure was 10.3%. After adjustment for demographic and clinical factors, the relative risk of mortality (RR 7.54, 95% CI 5.56, 10.44), pneumothorax (RR 9.85, 95% CI 2.89, 61.53), pulmonary haemorrhage (RR 7.78, 95% CI 4.51, 14.64) and BPD (RR 3.65, 95% CI 3.65, 4.51) were considerably higher for infants in the CPAP failure group than those in the CPAP‐S group. However, the risk of poor outcomes in CPAP failure infants was similar to that of those in the initial mechanical ventilation (MV) group. CONCLUSIONS: Continuous positive airway pressure failure was associated with an increased risk of mortality and major morbidities, including BPD, pulmonary haemorrhage and pneumothorax, and was comparable to the risk associated with initial MV. |
format | Online Article Text |
id | pubmed-9291106 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92911062022-07-20 Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study Wang, Li Li, Jia‐hui Yu, Yong‐hui Huang, Lei Huang, Xiao‐yang Fan, Xiu‐fang Zhang, Xiao‐hui Zhang, Chun‐lei Liu, Qiang Sun, Ai‐rong Zhang, Yong‐feng Cao, Yang‐yang Xu, Ping Liu, Xiu‐xiang Wu, Jing‐cai Yang, Zhen‐ying Sun, Rong‐rong Ren, Xue‐yun Li, Jing Wan, Xiao‐li Qiu, Bing‐ping Niu, Shi‐ping Zhu, Ren‐xia Wang, Xiao‐kang Zhang, Yi‐hui Gao, Yan‐ling Deng, Li‐ping Shi, Jing Bi, Mei‐rong Paediatr Perinat Epidemiol Perinatal and Infant Outcomes BACKGROUND: For initial respiratory management, continuous positive airway pressure (CPAP) is increasingly used for preterm infants, especially for gestational age less than 32 weeks. However, neonatologists are concerned about the potential risks of CPAP support failure. OBJECTIVES: To examine the association between different initial respiratory support modalities and the outcomes of preterm infants at <32 weeks of gestation across multiple neonatal intensive care units (NICU) in China. METHODS: This study was carried out over a period of 12 months in 2018. Unadjusted relative risks (RR) for demographic and clinical characteristics were calculated for CPAP failure and CPAP success in the total cohort using log‐linear model based on generalised estimating equations for clustered observations. RESULTS: Among 1560 preterm infants delivered at <32 weeks, the incidence of CPAP failure was 10.3%. After adjustment for demographic and clinical factors, the relative risk of mortality (RR 7.54, 95% CI 5.56, 10.44), pneumothorax (RR 9.85, 95% CI 2.89, 61.53), pulmonary haemorrhage (RR 7.78, 95% CI 4.51, 14.64) and BPD (RR 3.65, 95% CI 3.65, 4.51) were considerably higher for infants in the CPAP failure group than those in the CPAP‐S group. However, the risk of poor outcomes in CPAP failure infants was similar to that of those in the initial mechanical ventilation (MV) group. CONCLUSIONS: Continuous positive airway pressure failure was associated with an increased risk of mortality and major morbidities, including BPD, pulmonary haemorrhage and pneumothorax, and was comparable to the risk associated with initial MV. John Wiley and Sons Inc. 2021-08-24 2022-05 /pmc/articles/PMC9291106/ /pubmed/34431114 http://dx.doi.org/10.1111/ppe.12801 Text en © 2021 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Perinatal and Infant Outcomes Wang, Li Li, Jia‐hui Yu, Yong‐hui Huang, Lei Huang, Xiao‐yang Fan, Xiu‐fang Zhang, Xiao‐hui Zhang, Chun‐lei Liu, Qiang Sun, Ai‐rong Zhang, Yong‐feng Cao, Yang‐yang Xu, Ping Liu, Xiu‐xiang Wu, Jing‐cai Yang, Zhen‐ying Sun, Rong‐rong Ren, Xue‐yun Li, Jing Wan, Xiao‐li Qiu, Bing‐ping Niu, Shi‐ping Zhu, Ren‐xia Wang, Xiao‐kang Zhang, Yi‐hui Gao, Yan‐ling Deng, Li‐ping Shi, Jing Bi, Mei‐rong Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title | Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title_full | Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title_fullStr | Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title_full_unstemmed | Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title_short | Initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in China: A multicentre retrospective cohort study |
title_sort | initial respiratory support modality and outcome in preterm infants with less than 32 weeks of gestation in china: a multicentre retrospective cohort study |
topic | Perinatal and Infant Outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291106/ https://www.ncbi.nlm.nih.gov/pubmed/34431114 http://dx.doi.org/10.1111/ppe.12801 |
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