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Table 2 Predictors for an unsuccessful INSURE procedure in 291 neonates born before 32 weeks gestation, 1998–2010

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

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)

  1. Abbreviations: a/A-ratio, arterial to alveolar oxygen tension ratio; FiO2, fraction of inspired oxygen; long MV, mechanical ventilation for more than 24 hours; pCO2, partial pressure of carbon dioxide; pO2, partial pressure of oxygen; SBE, standard base excess; temp, temperature.
  2. *P < 0.05.
  3. 1Adjusted for gestational age, gender, and birth year using robust standard error correction for clustering. Gestational age was adjusted for gender and birth year. Gender was adjusted for gestational age and birth year.
  4. Percentage of missing values for each predictor: 2≤ 5%, 3≤ 10%, 4≤ 20%, 5≤ 30%, and 6≤ 40%.