Incidence, Predictors and Outcomes of Noninvasive Ventilation Failure in Very Preterm Infants

Non-invasive ventilation (NIV) is now considered the first-line treatment for respiratory distress syndrome in preterm infants. We aimed to evaluate the rates of non-invasive ventilation failure rate in very preterm infants, as well as to identify its predictors and associated outcomes. We designed a single-center retrospective cohort study including infants ≤32 weeks gestational age and ≤1500 g. The NIV failure was defined as the need for intubation at II (OR 6.22; 95% CI 1.36−28.3). These infants were significantly smaller in GA and weight. Higher FiO2 during resuscitation (OR 1.14; 95% CI 1.06−1.22) and after surfactant administration (OR 1.17; 95% CI 1.05−1.31) represented independent risk factors for NIV failure. In conclusion, NIV failure is frequent and it could be predicted by a higher oxygen requirement during resuscitation and a modest response to surfactant therapy. Importantly, this NIV failure is associated with worse clinical outcomes

Anesthesia · Bronchopulmonary dysplasia · Cohort · Gestational age · Incidence (geometry · Intraventricular hemorrhage · Intubation · Mechanical ventilation · Noninvasive ventilation · Oxygen therapy · Pregnancy · Respiratory distress · Respiratory failure · Resuscitation · Retrospective cohort study · Surfactant therapy · Ventilation (architecture · Congenital Diaphragmatic Hernia Studies · Medicine · Neonatal Respiratory Health Research · Respiratory Support and Mechanisms · Internal Medicine · Pediatrics