Effect of Prophylactic CPAP in Very Low Birth Weight Infants in South America

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2016 Apr 8

PMID 27054844

Citations 2

Authors

J R Zubizarreta

S A Lorch

G Marshall

I DApremont

J L Tapia

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to examine the effect of prophylactic continuous positive airway pressure (CPAP) on infants born in 25 South American neonatal intensive care units affiliated with the Neocosur Neonatal Network using novel multivariate matching methods.

Study Design: A prospective cohort was constructed of infants with a birth weight 500 to 1500 g born between 2005 and 2011 who clinically were eligible for prophylactic CPAP. Patients who received prophylactic CPAP were matched to those who did not on 23 clinical and sociodemographic variables (N=1268). Outcomes were analyzed using the McNemar's test.

Results: Infants not receiving prophylactic CPAP had higher mortality rates (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.17, 2.46), need for any mechanical ventilation (OR=1.68, 95% CI 1.33, 2.14) and death or bronchopulmonary dysplasia (BPD) (OR=1.47, 95% CI 1.09, 1.98). The benefit of prophylactic CPAP varied by birth weight and gender.

Conclusions: The implementation of this process was associated with a significant improvement in survival and survival free of BPD.

Citing Articles

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review.

Wastnedge E, Waters D, Murray S, McGowan B, Chipeta E, Nyondo-Mipando A J Glob Health. 2022; 11:04050.

PMID: 35003711 PMC: 8709903. DOI: 10.7189/jogh.11.04050.

National scale of neonatal CPAP to district hospitals in Malawi improves survival for neonates weighing between 1.0 and 1.3 kg.

Carns J, Liaghati-Mobarhan S, Asibon A, Chalira A, Lufesi N, Molyneux E Arch Dis Child. 2021; 107(6):553-557.

PMID: 34725045 PMC: 9125365. DOI: 10.1136/archdischild-2021-322964.

References

Cabana M, Rand C, Powe N, Wu A, Wilson M, Abboud P . Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999; 282(15):1458-65. DOI: 10.1001/jama.282.15.1458. View

Normand S, Landrum M, Guadagnoli E, Ayanian J, Ryan T, Cleary P . Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores. J Clin Epidemiol. 2001; 54(4):387-98. DOI: 10.1016/s0895-4356(00)00321-8. View

Wehby G, Lopez-Camelo J, Castilla E . Hospital volume and mortality of very low-birthweight infants in South America. Health Serv Res. 2012; 47(4):1502-21. PMC: 3360993. DOI: 10.1111/j.1475-6773.2012.01383.x. View

. Respiratory support in preterm infants at birth. Pediatrics. 2014; 133(1):171-4. DOI: 10.1542/peds.2013-3442. View

Magluta C, Gomes M, Wuillaume S . Difficulties in the dissemination and implementation of clinical guidelines in government neonatal intensive care units in Brazil: how managers, medical and nursing, position themselves. J Eval Clin Pract. 2011; 17(4):744-8. DOI: 10.1111/j.1365-2753.2011.01681.x. View

Tapia J, Urzua S, Bancalari A, Meritano J, Torres G, Fabres J . Randomized trial of early bubble continuous positive airway pressure for very low birth weight infants. J Pediatr. 2012; 161(1):75-80.e1. DOI: 10.1016/j.jpeds.2011.12.054. View

Sweet D, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R . European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants--2013 update. Neonatology. 2013; 103(4):353-68. DOI: 10.1159/000349928. View

Lopez S, Wong Y, Urbina L, Gomez I, Escobar F, Tinoco B . Quality in practice: preventing and managing neonatal sepsis in Nicaragua. Int J Qual Health Care. 2013; 25(5):599-605. DOI: 10.1093/intqhc/mzt060. View

Finer N, Carlo W, Walsh M, Rich W, Gantz M, Laptook A . Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010; 362(21):1970-9. PMC: 3071534. DOI: 10.1056/NEJMoa0911783. View

10.

Cabana M, Rand C, Becher O, Rubin H . Reasons for pediatrician nonadherence to asthma guidelines. Arch Pediatr Adolesc Med. 2001; 155(9):1057-62. DOI: 10.1001/archpedi.155.9.1057. View

11.

Carlo W . Gentle ventilation: the new evidence from the SUPPORT, COIN, VON, CURPAP, Colombian Network, and Neocosur Network trials. Early Hum Dev. 2012; 88 Suppl 2:S81-3. DOI: 10.1016/S0378-3782(12)70022-1. View

12.

Dos Santos A, Guinsburg R, Procianoy R, Sadeck L, Netto A, Rugolo L . Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units. Transfusion. 2009; 50(1):150-9. DOI: 10.1111/j.1537-2995.2009.02373.x. View

13.

Bloom B, Craddock A, Delmore P, Kurlinski J, Voelker M, Landfish N . Reducing acquired infections in the NICU: observing and implementing meaningful differences in process between high and low acquired infection rate centers. J Perinatol. 2003; 23(6):489-92. DOI: 10.1038/sj.jp.7210981. View

14.

Goyal N, Zubizarreta J, Small D, Lorch S . Length of stay and readmission among late preterm infants: an instrumental variable approach. Hosp Pediatr. 2013; 3(1):7-15. PMC: 3967867. DOI: 10.1542/hpeds.2012-0027. View

15.

Zhou Q, Lee S, Jiang S, Chen C, Kamaluddeen M, Hu X . Efficacy of an infection control program in reducing ventilator-associated pneumonia in a Chinese neonatal intensive care unit. Am J Infect Control. 2013; 41(11):1059-64. DOI: 10.1016/j.ajic.2013.06.007. View

16.

Ho J, Chang A . Changes in the process of care and outcome over a 10-year period in a neonatal nursery in a developing country. J Trop Pediatr. 2007; 53(4):232-7. DOI: 10.1093/tropej/fmm050. View

17.

BURSTEIN J, Papile L, Burstein R . Subependymal germinal matrix and intraventricular hemorrhage in premature infants: diagnosis by CT. AJR Am J Roentgenol. 1977; 128(6):971-6. DOI: 10.2214/ajr.128.6.971. View

18.

Neogi S, Malhotra S, Zodpey S, Mohan P . Assessment of special care newborn units in India. J Health Popul Nutr. 2011; 29(5):500-9. PMC: 3225112. DOI: 10.3329/jhpn.v29i5.8904. View

19.

Rosenbaum P, Silber J . Amplification of Sensitivity Analysis in Matched Observational Studies. J Am Stat Assoc. 2012; 104(488):1398-1405. PMC: 3416023. DOI: 10.1198/jasa.2009.tm08470. View

20.

Zubizarreta J, Reinke C, Kelz R, Silber J, Rosenbaum P . Matching for Several Sparse Nominal Variables in a Case-Control Study of Readmission Following Surgery. Am Stat. 2014; 65(4):229-238. PMC: 4237023. DOI: 10.1198/tas.2011.11072. View