Risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome

Abstract:

Objective To study the risk factors for the failure of the InSure method in very preterm infants with respiratory distress syndrome (RDS). Methods Seventy-one very preterm infants with RDS treated with InSure method were enrolled. These infants were categorized into two groups: InSure success (42 cases) and InSure failure (29 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for InSure failure. Results The failure rate of the InSure method was 41%. The failure group were much lower in the birth weight, the antenatal steroids utilization rate and the vaginal delivery rate than the success group (P<0.05). The incidence of patent ductus arteriosus in the failure group was significantly higher than in the success group (P<0.05). PaO₂, PaO₂/FiO₂ and PaO₂/PAO₂ in the failure group were significantly lower than in the success group (P<0.05). PaCO₂ in the failure group was much higher than in the success group (P<0.05). Further logistic regression analysis showed that birth weight <1 150 g (OR=22.240 95%CI=2.124-232.901), PaCO₂>54 mm Hg(OR=9.360, 95%CI=1.958-44.741, and PaO₂/FiO₂ <195 (OR=6.570, 95%CI=1.027-42.003), were the independmend risk factors for InSure failure. Furthermore, the duration of oxygen therapy, the total time of hospitalization and the incidence of BPD in the failure group were much longer and higher than in the success group (P<0.05). Conclusions Low birth weight, elevated PaCO₂ and low PaO₂/PiO2 ratio are the risk factors for the failure of the InSure method in very preterm infants.