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Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates
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Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates
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Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates
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Journal Article
Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates
2022
Overview
The frequency of non-invasive respiratory support use has increased in neonates of all gestational ages with respiratory distress (RD). However, the impact of delayed initiation of non-invasive respiratory support in outborn neonates remains poorly understood. This study aimed to identify the impact of the delayed initiation of non-invasive respiratory support in outborn, late-preterm, and term neonates. Medical records of 277 infants (gestational age of ≥ 35 weeks) who received non-invasive respiratory support as primary respiratory therapy < 24 h of age between 2016 and 2020 were retrospectively reviewed. Factors associated with respiratory adverse outcomes were investigated in 190 outborn neonates. Infants with RD were divided into two groups: mild (fraction of inspired oxygen [FiO
2
] ≤ 0.3) and moderate-to-severe RD (FiO
2
> 0.3), depending on their initial oxygen requirements from non-invasive respiratory support. The median time for the initiation of non-invasive respiratory support at a tertiary center was 3.5 (2.2–5.0) h. Male sex, a high oxygen requirement (FiO
2
> 0.3), high CO
2
level, and respiratory distress syndrome were significant factors associated with adverse outcomes. Subgroup analysis revealed that in the moderate-to-severe RD group, delayed commencement of non-invasive respiratory support (≥ 3 h) was significantly associated with pulmonary air leakage (
p
= 0.033).
Conclusion
: Our study shows that outborn neonates with moderate-to-severe RD, who were treated with delayed non-invasive respiratory support, were associated with an increased likelihood of pulmonary air leakage. Additional prospective studies are required to establish the optimal timing and methods of non-invasive respiratory support for outborn, late-preterm, and term infants.
What is Known:
• Non-invasive respiratory support is widely used in neonates of all gestational ages.
• Little is known on the impact of delayed initiation of non-invasive respiratory support in outborn, late preterm, and term neonates.
What is New:
• Male sex, high oxygen requirement (FiO2 >0.3), high initial CO2 level, and respiratory distress syndrome significantly correlated with adverse outcomes.
• Outborn late-preterm and term neonates with high oxygen requirement who were treated with delayed non-invasive respiratory support indicated an increased likelihood of pulmonary air leakage.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
