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[Predictive factors for failure of continuous positive airway pressure treatment in infants with bronchiolitis]

Si-Ying Luo1, Yi Wu, Qian Yi

  • 1Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/National Clinical Research Center for Child Health and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. luozhengxiu816@163.com.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|April 22, 2020
PubMed

Insights

Predictors of continuous positive airway pressure (CPAP) failure in infants with bronchiolitis include poor oxygenation, high Pediatric Risk of Mortality III (PRISM III) scores, atelectasis, and cardiac insufficiency. These factors aid in identifying infants at risk for CPAP treatment failure.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Critical Care

Background:

  • Bronchiolitis is a common respiratory infection in infants.
  • Continuous positive airway pressure (CPAP) is a key treatment for respiratory distress in infants with bronchiolitis.
  • Identifying factors predicting CPAP failure is crucial for timely intervention.

Purpose of the Study:

  • To identify predictive factors for the failure of CPAP treatment in infants diagnosed with bronchiolitis.
  • To analyze clinical data to understand outcomes of CPAP therapy.

Main Methods:

  • Retrospective analysis of clinical data from 310 infants (1-12 months) with bronchiolitis treated with CPAP.
  • Comparison of clinical features between successful (270 cases) and failed (40 cases) CPAP treatment groups.
  • Multivariate logistic regression analysis to determine predictive factors for CPAP failure.

Main Results:

  • Pediatric Risk of Mortality III (PRISM III) score ≥10 (OR=13.905), atelectasis (OR=12.080), cardiac insufficiency (OR=7.741), and lack of oxygenation improvement (P/F ratio <203) after 2 hours (OR=34.084) predicted CPAP failure.
  • Lack of P/F improvement had an AUC of 0.793, sensitivity of 70.3%, and specificity of 82.4% for predicting failure.

Conclusions:

  • Lack of P/F improvement within 2 hours, PRISM III score ≥10, atelectasis, and cardiac insufficiency are significant predictors of CPAP treatment failure in infants with bronchiolitis.
  • These factors can guide clinical decisions and resource allocation for managing infants with bronchiolitis requiring CPAP.
Abstract

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