Identifying Factors Associated with Prolonged Postoperative Mechanical Ventilation in Preterm Infants Undergoing...

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Respiratory Physiology

Background:

• Patent ductus arteriosus (PDA) is common in preterm infants and often requires surgical ligation.
• Prolonged mechanical ventilation (MV) post-ligation is a significant complication, impacting outcomes.
• Identifying factors predicting prolonged MV is crucial for optimizing care.

Purpose of the Study:

• To analyze factors associated with prolonged MV after PDA ligation in preterm infants.
• To identify high-risk neonates requiring closer perioperative monitoring.
• To utilize machine learning for predictive factor analysis.

Main Methods:

• Retrospective analysis of preterm infants (≤32 weeks) undergoing PDA ligation (2021-2025).
• Analysis of demographic, preoperative, and postoperative data.
• Application of machine learning and SHAP analysis to identify predictive factors.

Main Results:

• Significant differences in gestational age, birth weight, RSS, and post-ligation cardiac syndrome were observed between short (<6 days) and prolonged (>6 days) MV groups.
• Respiratory Severity Score (RSS) > 4.5 was the strongest predictor of prolonged MV (AUC = 0.865).
• Low birth weight and slow postoperative heart rate were associated with increased MV duration, while higher birth weight and heart rate correlated with shorter duration.

Conclusions:

• High RSS, low birth weight, and slow postoperative heart rate are key indicators for prolonged MV after PDA ligation.
• These factors can assist in identifying preterm infants at higher risk for extended ventilation.
• Targeted monitoring and intervention for high-risk infants may improve outcomes.