From: Predictors for an unsuccessful INtubation-SURfactant-Extubation procedure: a cohort study
Primary analyses INSURE failure vs. INSURE success | Secondary analyses Long MV vs. INSURE success | ||||||
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Predictors | INSURE success, n (%) (n = 100) | INSURE failure, n (%) (n = 33) | Crude OR | Adjusted OR (95% CI)1 | Long MV, n (%) (n = 158) | Crude OR | Adjusted OR (95% CI)1 |
Gestational age2 | |||||||
30 + 0 – 31 + 6 weeks (base) | 34 (34) | 3 (9) | 1.0 | 1.0 | 11 (7) | 1.0 | 1.0 |
28 + 0 – 29 + 6 weeks | 40 (40) | 16 (49) | 4.5 | 4.8 (1.3–18.0)* | 34 (22) | 2.6 | 3.1 (1.3–7.5)* |
26 + 0 – 27 + 6 weeks | 18 (18) | 8 (24) | 5.0 | 4.9 (1.1–21.2)* | 59 (37) | 10.1 | 11.4 (4.6–28.6)* |
– 25 + 6 weeks | 8 (8) | 6 (18) | 8.5 | 9.9 (1.8–55.6)* | 54 (34) | 20.9 | 26.3 (9.5–72.5)* |
Birth weight <1000 g2 | 27 (27) | 10 (30) | 1.2 | 0.3 (0.1–1.2) | 105 (67) | 5.5 | 1.6 (0.8–3.3) |
Small for gestational age2 | 42 (42) | 12 (36) | 0.8 | 0.9 (0.4–2.0) | 64 (41) | 1.0 | 1.3 (0.7–2.3) |
Gender (male)2 | 57 (57) | 19 (58) | 1.0 | 1.4 (0.6–3.2) | 97 (61) | 1.2 | 1.4 (0.7–2.6) |
Umbilical cord pH <7.35 | 26 (35) | 6 (24) | 0.6 | 0.7 (0.2–2.1) | 42 (36) | 1.0 | 1.1 (0.5–2.4) |
Umbilical cord SBE < -3 mmol/l6 | 18 (26) | 5 (24) | 0.9 | 0.6 (0.2–2.0) | 46 (42) | 2.0 | 1.3 (0.6–2.8) |
Apgar at 1 minute <72 | 30 (30) | 8 (25) | 0.8 | 0.5 (0.2–1.3) | 76 (48) | 2.2 | 1.7 (0.9–3.3) |
Apgar at 5 minutes <72 | 4 (4) | 2 (6) | 1.6 | 1.4 (0.2–10.6) | 23 (15) | 4.1 | 4.7 (1.0–20.9)* |
Temp at admission to NICU <35.5°C3 | 13 (14) | 4 (14) | 1.0 | 0.7 (0.2–2.7) | 36 (25) | 2.0 | 1.1 (0.5–2.7) |
Surfactant given <5 hours after birth2 | 24 (24) | 13 (39) | 2.1 | 1.3 (0.5–3.5) | 104 (66) | 6.1 | 3.3 (1.7–6.2)* |
a/A-ratio <0.204 | 33 (34) | 5 (17) | 0.4 | 0.6 (0.2–1.8) | 38 (31) | 0.9 | 1.3 (0.6–2.7) |
FiO2 > 0.503 | 31 (33) | 9 (29) | 0.8 | 1.3 (0.5–3.6) | 74 (50) | 2.0 | 2.7 (1.3–5.3)* |
pO2 < 7.5 kPa (~56 mmHg)5 | 17 (20) | 5 (17) | 0.8 | 0.8 (0.2–2.9) | 28 (26) | 1.4 | 1.1 (0.5–2.6) |
pCO2 > 7 kPa (~53 mmHg)4 | 16 (18) | 10 (33) | 2.2 | 2.0 (0.7–5.8) | 62 (50) | 4.4 | 4.3 (1.9–9.6)* |
pH <7.36 | 30 (43) | 13 (54) | 1.5 | 1.8 (0.7–4.9) | 65 (67) | 2.6 | 3.9 (1.7–8.8)* |
SBE < -3 mmol/l6 | 20 (29) | 6 (25) | 0.8 | 0.6 (0.2–1.9) | 48 (49) | 2.4 | 1.7 (0.7–3.8) |
Hemoglobin <8.5 mmol/l6 | 2 (3) | 5 (21) | 8.6 | 5.1 (1.0–25.8)* | 14 (15) | 5.8 | 4.8 (0.7–34.7) |
Lactate >2.5 mmol/l6 | 25 (37) | 6 (25) | 0.6 | 0.6 (0.2–1.9) | 54 (59) | 2.4 | 2.7 (1.3–5.7)* |
Mean blood pressure < gestational age6 | 9 (13) | 2 (12) | 0.9 | 1.0 (0.2–6.9) | 16 (17) | 1.4 | 1.7 (0.6–5.2) |
Inotropes prior to intubation2 | 2 (2) | 1 (3) | 1.5 | 0.9 (0.2–5.2) | 17 (11) | 5.9 | 8.8 (1.2–66.7)* |
Nulliparity2 | 59 (60) | 23 (72) | 1.7 | 1.8 (0.7–4.8) | 87 (58) | 0.9 | 0.9 (0.5–1.6) |
Multiple pregnancy2 | 45 (45) | 16 (48) | 1.2 | 0.9 (0.4–2.1) | 66 (42) | 0.9 | 0.6 (0.3–1.1) |
Preeclampsia3 | 24 (26) | 8 (25) | 0.9 | 1.2 (0.4–3.2) | 18 (12) | 0.4 | 0.4 (0.2–0.8)* |
Prolonged rupture of membranes3 | 8 (8) | 1 (3) | 0.4 | 0.2 (0.0–2.2) | 16 (11) | 1.4 | 1.1 (0.4–3.4) |
Maternal age at delivery >30 years2 | 48 (48) | 16 (48) | 1.0 | 1.3 (0.5–3.0) | 86 (55) | 1.3 | 1.6 (0.9–3.1) |
No antenatal steroids2 | 9 (9) | 4 (13) | 1.4 | 1.4 (0.4–5.4) | 14 (9) | 1.0 | 0.8 (0.3–2.0) |
Cesarean delivery (vs. vaginal)2 | 72 (72) | 23 (70) | 0.9 | 1.5 (0.6–4.0) | 95 (60) | 0.6 | 1.0 (0.5–1.9) |