Related Experiment Video
Updated: Jun 7, 2025

Laryngeal Mask Airway LMA Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway SGA
Published on: July 14, 2023
[Risk factors and adverse outcomes of initial non-invasive ventilation failure in very low birth weight infants: a
1Department of Neonatology, Lianyungang Maternal and Child Health Hospital, Lianyungang222000, China.
Abstract:
Objective: To investigate the risk factors of initial non-invasive ventilation(NIV) failure and its association with adverse outcomes in very low birth weight infants (VLBWI). Methods: A retrospective cohort study was conducted, collecting clinical data of 2 102 VLBWI who received NIV within 30 minutes after birth, admitted to 18 NICU of Suxinyun Neonatal Perinatal Collaboration Network (SNPN) from January 1st, 2019 to December 31st, 2022. According to the outcome of NIV within the first 72 hours, the study cohort was divided into success group and failure group. Univariate analysis and multivariate Logistic regression analysis were performed to identify risk factors for NIV failure and its association with adverse outcome. Results: A total of 2 102 VLBWI were included, consisting of 1 078 males (51.3%). The gestational age was 29 (28, 31) weeks, and the birth weight was 1 250 (1 090, 1 380) g. The initial NIV failure rate was 15.3%(321/2 102). Multivariate Logistic regression analysis showed that smaller gestational age (OR=0.67, 95%CI 0.61-0.74, P<0.001), maternal hypertensive disorders during pregnancy (OR=10.31, 95%CI 7.48-14.21, P<0.001), Apgar score at the first minute ≤7 (OR=1.40, 95%CI 1.01-1.93, P=0.042), grade 3-4 respiratory distress syndrome (RDS)(OR=2.85, 95%CI 1.69-4.81, P<0.001), ≥2 times pulmonary surfactant (PS) treatment (OR=3.78, 95%CI 2.09-6.83, P<0.001), fraction of inspired oxygen (FiO2)>0.30 (OR=2.21, 95%CI 1.64-2.98, P<0.001) were all independent risk factors for initial NIV failure. The failure group had higher risks of mortality (OR=10.19, 95%CI 6.50-15.97, P<0.001), pneumothorax (OR=4.33, 95%CI 1.59-11.79, P=0.004), neonatal pulmonary hemorrhage (OR=8.48, 95%CI 4.08-17.64, P<0.001), moderate to severe bronchopulmonary dysplasia (BPD)(OR=1.75, 95%CI 1.19-2.56, P=0.004), and intraventricular hemorrhage (IVH) ≥grade Ⅲ (OR=2.18, 95%CI 1.27-3.73, P=0.004) compared to the success group. Conclusions: Small gestational age, maternal hyertensive disorders during pregnancy, Apgar score at the first minute ≤7, grade 3-4 RDS, PS treatment ≥2 times and FiO2 >0.30 are risk factors for initial NIV failure in VLBWI. Initial NIV failure is associated with increased risk of mortality, pneumothorax, pulmonary hemorrhage, moderate to severe BPD, and IVH ≥grade Ⅲ.
Related Concept Videos
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Mechanical Ventilation I: Indication and Settings
Acute Respiratory Failure-III
Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...

