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Factors associated with long-term mechanical ventilation in extremely preterm infants
Lina Yossef1, Edward G Shepherd2,3, Susan Lynch2,3
1Ohio Perinatal Research Network, Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Journal of Neonatal-Perinatal Medicine
|April 26, 2018
Summary
Thirty-five percent of extremely preterm infants required long-term intermittent positive pressure ventilation (IPPV). Transfer from another NICU and dopamine use were associated with this prolonged ventilation need.
Area of Science:
- Neonatalogy
- Pediatric Critical Care
- Respiratory Medicine
Background:
- Extremely preterm infants (<27 weeks gestation) often require respiratory support.
- Long-term intermittent positive pressure ventilation (IPPV) is a significant concern in this vulnerable population.
- Identifying associated factors is crucial for optimizing care and outcomes.
Purpose of the Study:
- To determine factors associated with long-term IPPV in extremely preterm infants.
- To identify predictors of prolonged mechanical ventilation in neonates.
- To inform clinical practice and improve respiratory support strategies.
Main Methods:
- Retrospective cohort study of infants born at <27 weeks gestation admitted to a Level IV NICU.
- Inclusion criteria: alive at 56 days of age.
- Data analysis included logistic regression to identify factors associated with long-term IPPV (≥56 days).
Main Results:
- 35% of the 210 infants required long-term IPPV.
- Infants on long-term IPPV were born earlier, had lower birth weight, and were more likely to be transferred from Level III NICUs.
- Logistic regression identified transfer from another Level III NICU (OR 3.7) and dopamine administration (OR 3.1) as significant predictors of long-term IPPV.
Conclusions:
- A substantial proportion of extremely preterm infants require prolonged mechanical ventilation.
- Factors present on admission and during the NICU stay predict the need for long-term IPPV.
- Early identification of at-risk infants and targeted interventions may reduce the duration of mechanical ventilation.
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