Abstract Objective To study the risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome (RDS). Methods 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. Results 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 (PP2, PaO2/FiO2 and PaO2/PAO2 in the failure group were significantly lower than in the success group (P2 in the failure group was much higher than in the success group (POR=22.240 95%CI=2.124-232.901), PaCO2>54 mm Hg(OR=9.360, 95%CI=1.958-44.741, and PaO2/FiO2 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 (PConclusions 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.
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Cite this article:
LI Ting,JIANG Hong,LIU Dong-Yun et al. Risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome[J]. CJCP, 2014, 16(6): 610-613.
LI Ting,JIANG Hong,LIU Dong-Yun et al. Risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome[J]. CJCP, 2014, 16(6): 610-613.
Sweet D, Bevilacqua G, Carnielli V, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome[J].Perinat Med, 2007, 35(1): 175-186.
Dani C, Bertini G, Pezzati M, et al. Early extubation and nasal continuous positive airway pressure after surfactant treatment for respiratory distress syndrome among preterm infants <30 weeks' gestation[J].Pediatrics, 2004, 113(6): e560-e563.
[6]
Stevens TP, Harrington EW, Blennow M, et al. Early surfactant administration with brief ventilation vs. selective surfactant andcontinued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome[J/OL]. Cochrane Database Syst Rev, 2007(4): CD003063.
Reininger A, Khalak R, Kendig JW, et al. Surfactant administration by transient intubation in infants 29 to 35 weeks' gestation with respiratory distress syndrome decreases the likelihood of later mechanical ventilation: a randomized controlled trial[J].Perinatol, 2005, 25(11): 703-708.
[9]
David G. Sweet, Virgilio Carnielli, Gorm Greisen, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 Update[J].Neonatology, 2013, 103(4): 353-368.
[10]
Dani C, Corsini I, Bertini G, et al. The INSURE method in preterm infants of less than 30 weeks'gestation[J].Matern Fetal Neonatal Med, 2010, 23(9): 1024-1029.
[11]
Cherif A, Hachani C, Khrouf N. Risk factors of the failure of surfactant treatment by transient intubation during nasal continuous positive airway pressure in preterm infants[J].Am J Perinatol, 2008, 25(10): 647-652.
[12]
Jobe AH, Mitchell RR, Gunkel JH. Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants[J].Am J Obstet Gynecol 1993, 168(2): 508-513.
