Nasal Intermittent Positive Pressure Ventilation and Bronchopulmonary Dysplasia Among Very Preterm Infants Never Intubated During the First Neonatal Admission: A Multicenter Cohort Study

Frontiers in Pediatrics

article

Alejandro Avila-Alvarez¹  Fermín García-Muñoz Rodrigo³  Gonzalo Solís-García⁴  Sonia Pertega-Diaz²  Manuel Sánchez Luna⁶  Martin Iriondo-Sanz⁷  Dolores Elorza Fernandez⁸  Carlos Zozaya⁸ 

[1] Neonatal Unit, Department of Pediatrics, Complejo Hospitalario Universitario A Coruña;A Coruña Biomedical Research Institute;Division of Neonatology, Complejo Hospitalario Universitario Insular - Materno Infantil;Division of Neonatology, Hospital for Sick Children, University of Toronto;Research Support Unit, Complejo Hospitalario Universitario A Coruña;Division of Neonatology, Hospital General Universitario Gregorio Marañón;Division of Neonatology, Hospital Sant Joan de Déu, BCNatal, Barcelona University;Division of Neonatology, Hospital Universitario La Paz

关键词: very preterm infants;    bronchopulmonary dysplasia;    non-invasive ventilation;    preterm outcomes;    nasal intermittent positive pressure ventilation;   

DOI  :  10.3389/fped.2022.896331

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction While non-invasive positive-pressure ventilation (NIPPV) is increasingly used as a mode of respiratory support for preterm infants, it remains unclear whether this technique translates into improved respiratory outcomes. We assessed the association between NIPPV use and bronchopulmonary dysplasia (BPD)-free survival in never intubated very preterm infants. Methods This multicenter cohort study analyzed data from the Spanish Neonatal Network SEN1500 corresponding to preterm infants born at <32 weeks gestational age and <1,500 g and not intubated during first admission. The exposure of interest was use of NIPPV at any time and the main study outcome was survival without moderate-to-severe BPD. Analyses were performed both by patients and by units. Primary and secondary outcomes were compared using multilevel logistic-regression models. The standardized observed-to-expected (O/E) ratio was calculated to classify units by NIPPV utilization and outcome rates were compared among groups. Results Of the 6,735 infants included, 1,776 (26.4%) received NIPPV during admission and 6,441 (95.6%) survived without moderate-to-severe BPD. After adjusting for confounding variables, NIPPV was not associated with survival without moderate-to-severe BPD (OR 0.84; 95%CI 0.62–1.14). A higher incidence of moderate-to-severe BPD-free survival was observed in high- vs. very low-utilization units, but no consistent association was observed between O/E ratio and either primary or secondary outcomes. Conclusion NIPPV use did not appear to decisively influence the incidence of survival without moderate-to-severe BPD in patients managed exclusively with non-invasive ventilation.

【 授权许可】

CC BY