Predictors of successful trial off continuous positive airway pressure and high flow nasal cannula in preterm infants <30 weeks' gestation: A retrospective study

Nada Mohsen; Nehad Nasef; Mohamed Elkhouli; Mohab Ghanem; Allison Dalby; Eugene Woojin Yoon; Emer Finan; Prakesh S Shah; Adel Mohamed

doi:10.1002/ppul.25827

Predictors of successful trial off continuous positive airway pressure and high flow nasal cannula in preterm infants <30 weeks' gestation: A retrospective study

Pediatr Pulmonol. 2022 Apr;57(4):1000-1007. doi: 10.1002/ppul.25827. Epub 2022 Jan 25.

Authors

Nada Mohsen^{1

2

3}, Nehad Nasef³, Mohamed Elkhouli^{1

2}, Mohab Ghanem^{1

2}, Allison Dalby², Eugene Woojin Yoon², Emer Finan^{1

2}, Prakesh S Shah^{1

2

4}, Adel Mohamed^{1

2}

Affiliations

¹ Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
² Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
³ Department of Pediatrics, Mansoura University, Mansoura, Egypt.
⁴ Institute of Health Policy, Management and Evaluation (HPME), University of Toronto, Toronto, Ontario, Canada.

PMID: 35032109
DOI: 10.1002/ppul.25827

Abstract

Objectives: To identify the predictors of successful first trial off nasal continuous positive airway pressure (nCPAP).

Methods: A retrospective cohort study of infants ≤29 weeks' gestation who required nCPAP for >24 h was conducted. Logistic regression was used to detect predictors for successful trial off nCPAP. Statistical analysis was performed using the SAS software.

Results: A total of 727 infants were included in the analysis. Infants who were successful in their first trial off nCPAP (n = 313) were of higher gestational age (GA) and birth weight (BW), as well as a higher proportion of female infants, compared with those who were not successful (p < 0.01). When stratified by GA, a negative correlation was noted between GA and postmenstrual age at successful trial off nCPAP or high flow nasal cannula (HFNC) (r = 0.45, p < 0.01). Logistic regression analysis showed that GA (odds ratio [OR] 1.13, 95% confidence interval [CI] [1.03-1.24], p = 0.01) and percentage of time spent with an oxygen saturation over 89% in the 24 h preceding the trial off nCPAP (OR 1.08, 95% CI [1.05-1.11], p = 0.00) were independent predictors for successful trial off nCPAP.

Conclusion: Successful trial off nCPAP or HFNC in preterm infants is significantly associated with higher GA, BW, female gender, and the specific oxygen saturation histogram in the preceding 24-h period.

Keywords: high flow nasal cannula; nasal continuous positive airway pressure; noninvasive ventilation; oxygen saturation histogram; preterm infant.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
Cannula
Continuous Positive Airway Pressure*
Female
Gestational Age
Humans
Infant
Infant, Newborn
Infant, Premature
Pregnancy
Respiratory Distress Syndrome, Newborn* / therapy
Retrospective Studies

Grants and funding

CIHR/Canada