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Arch Iran Med. 2020;23(11): 724-731.
doi: 10.34172/aim.2020.96
  Abstract View: 83
  PDF Download: 85

Original Article

Predictors of Success Rate in Different Initial Respiratory Supports in Very Low Birthweight Infants with Respiratory Distress

Minoo Fallahi 1,2 ORCID logo, Naeeme Taslimi Taleghani 1,2* ORCID logo, Seyyed Abolfazl Afje 1,2, Ahmad Reza Shamshiri 3, Fatemeh Esmaili 2, Mitra Radfar 1, Majid Jafari 4

1 Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Clinical Research Development Center, Mahdiyeh Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Allergy and Immunology, Mashhad University of Medical Sciences, Mashhad, Iran
*Corresponding Author: Naeeme Taslimi Taleghani, MD; Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Address: Shariati Ave, Tehran 15468-155514, Iran. Fax: +98-21-2222-0254, Tel: +98-21- 2222-7021(-9); Email: naeemetaslimi@ yahoo.com; naeemetaslimi@sbmu.ac.ir

Abstract

Background: Ideal respiratory support for very low birth weight infants (VLBW) can be selected based on demographic and clinical status at birth.

Methods: In this prospective cohort study, we included 163 VLBW neonates treated with either invasive or non-invasive respiratory support in their first 72 hours of life in the neonatal intensive care unit of Mahdiyeh hospital, Tehran, Iran. We used descriptive statistics to describe the data, and multiple logistic regression to determine the factors associated with the success rate of different strategies and the choice of strategy for primary respiratory support. All analyses were done using SPSS version 20 and STATA version 12 at a significance level of 0.05.

Results: The success rates of initial respiratory supports with nasal continuous positive airway pressure (NCPAP), noninvasive positive pressure ventilation (NIPPV), and INSURE (intubation surfactant extubation) were 63.20%, 42.10% and 61.90%, respectively. The results of multiple logistic regression analysis showed patent arterial duct (PDA) (yes vs. no: OR = 0.42) had a significant effect on initial respiratory support success (P<0.05). Also, gestational age (>28 vs. ≤28 weeks: OR = 0.26) and 5-min APGAR (≤6 vs. >6: OR = 9.69) had a significant effect on the choice of initial respiratory support in VLBW infants (P<0.05).

Conclusion: The neonatal clinical condition may be a predictor of success for initial respiratory support at birth. Since the arterial duct may be open during the first hours of life, more study is needed to verify if early closure of the arterial duct may help increase the success rate of non-invasive respiratory support.

Keywords: Mechanical ventilation, Non-invasive ventilation, Respiratory distress syndrome, Surfactant, Very low birth weight infant
Cite this article as: Fallahi M, Taslimi Taleghani N, Afje SA, Shamshiri AR, Esmaili F, Radfar M, et al. Predictors of success rate in different initial respiratory supports in very low birthweight infants with respiratory distress. Arch Iran Med. 2020;23(11):724–731. doi: 10.34172/aim.2020.96.
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Submitted: 06 Mar 2019
Accepted: 06 Sep 2020
ePublished: 01 Nov 2020
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