Association of delayed initiation of non-invasive respiratory support with pulmonary air leakage in outborn late-preterm and term neonates

Abstract The frequency of non-invasive ventilation (NIV) use increased in neonates of all gestational ages with respiratory distress (RD). However, the impact of delayed initiation of NIV support in outborn neonates remains poor understood. The aim of the present study was to identify the impact of delayed initiation of NIV in outborn late-preterm and term neonates. The medical records of 277 infants (gestational age of ≥ 35 weeks) who were received NIV as primary respiratory therapy <24 h of age between 2016 and 2020 were retrospectively reviewed. Among the 190 outborn neonates, the factors associated with respiratory adverse outcomes were investigated. Infants with RD divided into two groups, mild (FiO2 ≤0.3) and moderate-to-severe RD group (FiO2 >0.3), depending on initial oxygen requirement under NIV support. Median time to start of NIV support at tertiary center was 3.5 (2.2–5.0) h. Male sex (odds ratio [OR], 2.9; 95% CI, 1.1–7.7), high oxygen requirement (FiO2 >0.3) (OR, 4.8; 95% CI, 1.5–15.3), and respiratory distress syndrome (OR, 10.4; 95% CI, 3.9–27.8) were the significant factors associated with adverse outcomes. Subgroup analysis revealed that in the moderate-to-severe RD group, delayed initiation of NIV (≥3 h) was significantly associated with pulmonary air leakage (p=0.033).Conclusions: Our study shows that outborn neonates with moderate-to-severe RD who were treated with delayed NIV were associated with an increased likelihood of pulmonary air leakage. Additional prospective studies are needed to establish the optimal timing and methods of NIV support for outborn late-preterm and term infants.

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Non-invasive Respiratory Support in Pre-term Neonates and Pediatric Patients with Respiratory Failure

Yearbook of Intensive Care and Emergency Medicine ◽

10.1007/3-540-33396-7_37 ◽

2006 ◽

pp. 400-414

Author(s):

P. Pelosi ◽

G. Chidini ◽

E. Calderini

Keyword(s):

Respiratory Failure ◽

Pediatric Patients ◽

Respiratory Support ◽

Term Neonates ◽

Non Invasive

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Non-invasive Respiratory Support in Pre-term Neonates and Pediatric Patients with Respiratory Failure

Intensive Care Medicine ◽

10.1007/0-387-35096-9_37 ◽

2007 ◽

pp. 400-414 ◽

Cited By ~ 1

Author(s):

P. Pelosi ◽

G. Chidini ◽

E. Calderini

Keyword(s):

Respiratory Failure ◽

Pediatric Patients ◽

Respiratory Support ◽

Term Neonates ◽

Non Invasive

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A case of significant subcutaneous emphysema on non-invasive respiratory support in a late preterm infant

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2017-0031 ◽

2017 ◽

Vol 7 (1) ◽

Author(s):

Satyaranjan Pegu ◽

Jaya P. Bodani ◽

Bakul Deb

Keyword(s):

Mechanical Ventilation ◽

Subcutaneous Emphysema ◽

Airway Pressure ◽

Positive Airway Pressure ◽

Late Preterm ◽

Respiratory Support ◽

Late Preterm Infant ◽

Preterm Baby ◽

Non Invasive ◽

Premature Babies

Abstract Air leaks are known complications associated with mechanical ventilation, with a higher incidence in more premature babies. Pneumothorax and pneumomediastinum are the most common ones and the majority would resolve spontaneously without active intervention. Subcutaneous emphysema is very rare, with few reported cases in neonates. We report here a case of extensive subcutaneous emphysema, pneumothorax and pneumomediastinum in a late preterm baby developed while on nasal continuous positive airway pressure (nCPAP) respiratory support.

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Impact of urine osmolality/urine sodium on the timing of diuretic phase and non-invasive ventilation support: Differences from late preterm to term neonates

Pediatrics & Neonatology ◽

10.1016/j.pedneo.2019.04.006 ◽

2020 ◽

Vol 61 (1) ◽

pp. 25-30

Author(s):

Yu-Hsuan Chien ◽

Yi-Ling Chen ◽

Li-Yi Tsai ◽

Shu-Chi Mu

Keyword(s):

Urine Osmolality ◽

Late Preterm ◽

Invasive Ventilation ◽

Urine Sodium ◽

Term Neonates ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Ventilation Support

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Hemodynamic Patterns Determined By Non-Invasive Cw-Doppler Ultrasound Cardiac Monitoring (USCOM) in Preterm Neonates with Respiratory Distress Syndrome During Non-Invasive Respiratory Support

Pediatrician (St Petersburg) ◽

10.17816/ped8341-46 ◽

2017 ◽

Vol 8 (3) ◽

pp. 41-46

Author(s):

Vera A. Sergeeva ◽

Yuri S. Alexandrovich ◽

Denis M. Strelkov ◽

Kseniya A. Siniuk

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Diastolic Dysfunction ◽

Doppler Ultrasound ◽

Distress Syndrome ◽

Respiratory Support ◽

Preterm Neonates ◽

Term Neonates ◽

Non Invasive ◽

Bedside Method

Aim: To determine the hemodynamic patterns in preterm neonates with respiratory distress syndrome (RDS) using the USCOM-1A technology. Materials and Methods: The USCOM device is a bedside method of evaluating cardiac output (CO) based on continuous-wave Doppler ultrasound. Hemodynamic parameters were measured daily for 7 days in 32 preterm neonates 32 ± 1 weeks of gestation (1688 ± 111 g) with RDS requiring noninvasive respiratory support (NCPAP, NIPPV, HFNC) and no catecholamine support in comparison with 28 healthy term neonates (3100 ± 690 g). Results: At day 1, preterm neonates had lower SVI (18 ± 5 vs 28 ± 8 ml m-2, p = 0.043) and higher SVRI (1585 ± 245 vs 1035 ± 358 dyn s cm-5 m2, p = 0.013) with a tendency for lower cardiac index (2.6 ± 0.8 vs 4.0 ± 1.3 l min-1 m-2, p = 0.089). Together with no difference in SMII, it indicates the presence of diastolic dysfunction with low preload. It is noted that all parameters had not changed by day 7 in preterm neonates, whereas term neonates demonstrated significantly increased SMII reflecting postnatal cardiovascular adaptation. Compared with preterm neonates with RDS requiring NCPAP/NIPPV, preterm neonates requiring HFNC had higher levels of FTc (330 ± 59 vs 388 ± 41 ms, р = 0.045), SVI (13 ± 3 vs 18 ± 4, ml/m2, р = 0.007), SMII (0.41 ± 0.09 vs 0.57 ± 0.21, р = 0.02), and CI (2.2 ± 0.6 vs 4.5 ± 0.9 l/min/m2, р = 0.006). Conclusions:Noninvasive respiratory support in preterm neonates with RDS may lead to diastolic dysfunction that is less prominent in neonates with HFNC.

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