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Outcomes of preterm infants receiving positive pressure support at term corrected gestation

Authors


  • Conflict of interest: None declared.

Abstract

Aim

To establish the mortality rate to hospital discharge of very preterm infants who remain on positive pressure support (PPS) at term corrected gestation and describe factors that are associated with increased mortality.

Methods

Infants born <30 weeks' gestation between 1 January 2001 and 31 December 2009 who were receiving PPS at 40 weeks' postmenstrual age (PMA) were identified from our database, and their medical records reviewed. The fraction of inspired oxygen (FiO2), mean airway pressure and partial pressure of carbon dioxide (PaCO2) at 40 weeks' PMA were recorded. Receiver operating characteristic curves for mortality before discharge were generated.

Results

One thousand three hundred fifty-nine of 1572 infants survived to term. Forty-nine infants were receiving PPS at 40 weeks' PMA. Of these, 15 (31%) infants died before hospital discharge. All three infants who were ventilated via an endotracheal tube died. Increased oxygen requirement at term was associated with increased risk of death before discharge (area under curve (AUC) 0.75). FiO2 > 0.5 was associated with an 80% risk of death. PaCO2 was not predictive of death (AUC 0.49).

Conclusions

Two thirds of very preterm infants who remained on PPS at 40 weeks' PMA survived to hospital discharge. Risk of death rises with increasing oxygen requirements. All five infants with FiO2 > 0.70 died.

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