ArticleNeonatology2019
Fraction of Inspired Oxygen as a Predictor of CPAP Failure in Preterm Infants with Respiratory Distress Syndrome: A Prospective Multicenter Study.
Article in Neonatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Two Fraction Oxygen Inspired (FiO2) Thresholds for the Surfactant Administration in Preterm Infants With Respiratory Disease Syndrome: a Single-center Randomized Phase IV Clinical Trial
Predictors for Nasal Intermittent Positive Pressure Ventilation Failure for Premature Infants With Respiratory Distress Syndrome
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update.Neonatology · 2023Guideline
- Diaphragmatic ultrasound and thoracic fluid content for prediction of non-invasive ventilation failure in neonates: a randomized controlled trial.European journal of pediatrics · 2025Trial
- Pulmonary Surfactant Treatment for Preterm Infants With Respiratory Distress Syndrome: A Nationwide Survey.The clinical respiratory journal · 2026Article
- Pulmonary comorbidities and response to surfactant in late preterm infants: a multicenter cohort study.Pediatric research · 2026Observational
- Article
- Early Prediction of Mechanical Ventilation Needs in Very Preterm Neonates Using Machine Learning.Pediatric pulmonology · 2025Article
- Changes in practice of less-invasive surfactant administration (LISA) in United Kingdom neonatal units.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Using a simplified Downes score to predict the receipt of surfactant in a highly resourced setting.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Decreasing early invasive mechanical ventilation exposure in preterm infants: a quality improvement initiative.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Identification of Neonatal Factors Predicting Pre-Discharge Mortality in Extremely Preterm or Extremely Low Birth Weight Infants: A Historical Cohort Study.Children (Basel, Switzerland) · 2024Article
- A nationwide survey on the management of neonatal respiratory distress syndrome: insights from the MUNICH survey in 394 Chinese hospitals.Italian journal of pediatrics · 2024Article
- Evaluation of a respiratory care protocol including less invasive surfactant administration in preterm infants.Pediatric research · 2024Article
- The Outcomes of Preterm Infants with Neonatal Respiratory Distress Syndrome Treated by Minimally Invasive Surfactant Therapy and Non-Invasive Ventilation.Biomedicines · 2024Article
- Review
- Early factors associated with continuous positive airway pressure failure in moderate and late preterm infants.European journal of pediatrics · 2023Observational
- RDS-NExT workshop: consensus statements for the use of surfactant in preterm neonates with RDS.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- CPAP failure in the management of preterm neonates with respiratory distress syndrome where surfactant is scarce. A prospective observational study.BMC pediatrics · 2023Observational
- Predicting the need for intubation within 3 h in the neonatal intensive care unit using a multimodal deep neural network.Scientific reports · 2023Article
- Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?Pediatric research · 2023Review
- Nasal intermittent positive pressure ventilation as a rescue therapy after nasal continuous positive airway pressure failure in infants with respiratory distress syndrome.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThere are limited data available regarding the fraction of inspired oxygen (FiO2) predictive of the failure of continuous positive airway pressure (CPAP) in preterm infants with respiratory distress syndrome (RDS). Therefore, we investigated factors predictive of CPAP failure in the first 72 h of life, with special attention to the prognostic role of FiO2.
methodsThis multicenter, prospective study enrolled infants <30 weeks gestation in whom CPAP was initiated within the first 15 min after birth. In the univariate and multivariate logistic regression models, demographic, perinatal, and respiratory parameters were analyzed. The FiO2 threshold was determined with ROC curve analysis.
resultsOf 389 recruited newborns, CPAP failure occurred in 108 infants (27.8%). In the univariate model, each gestational week reduced the odds of CPAP failure by 19%, and each 100 g of birth weight reduced the odds by 16% (both p < 0.05). The risk was increased by 4.2 and 7.5% for each 0.01 increase in FiO2in the first and second hours of life, respectively. In the final multivariate model, birth weight and FiO2 in the second hour of life were the predictive measures. The prognostic threshold was FiO2 = 0.29 in the second hour of life (AUC 0.7; p < 0.0001), with a sensitivity of 73% and a specificity of 57%. CPAP failure implied a more than 20-fold higher risk of death and pneumothorax and a 2- to 5-fold higher risk of typical complications of prematurity, including bronchopulmonary dysplasia and severe intraventricular hemorrhage.
conclusionFiO2 in the second hour of life is a significantpredictor of CPAP failure. The threshold of 0.29 best discriminates the CPAP outcome. Nonresponders to CPAP have a remarkably higher incidence of complications and a higher mortality rate.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.