Background: The most frequent disorders of admission
in neonatal intensive care unit is respiratory distress syndrome.
Continuous positive airway pressure (CPAP) is essential to
maintains functional residual capacity. Many predictors of
CPAP failure have been reported in studies
Aim of Study: This study aimed to evaluate the early
predictors of the failed continuous positive airway pressure
(CPAP) in preterm babies with respiratory distress syndrome
(RDS).
Patients and Methods: All born preterm neonates with
gestational age (GA) 36 weeks or less from December 2020
to October 2022, in whom CPAP was initiated within the first
72 hours after birth and FIO2 level was determined in the
first 2 hours of life, were enrolled in the study.
Results: Of the 207 neonates 36 weeks gestation or less
in the study, 7 neonates were excluded from the analysis, so
200 neonates were included. In the vast majority of neonates
with CPAP failure, the following factors were highly significant
explaining CPAP failure as birth weight and FiO2 level at the
first & second hours of life compared to CPAP success patients.
In ROC analysis, FiO2 - 1 sthr. at cut off point >0.38 and
FiO2 - 2ndhr. at cut off point >0.33 achieved significance for
predicting CPAP failure with sensitivity of (72%, 87%) and
specificity of (66.7%, 70.2%), with PPV (68%, 79%) and
NPV (70%, 82%), respectively.
Conclusion: FiO2 - 1 sthr> 0.38 and FiO2 - 2ndhr. >0.33
predict CPAP failure in preterm neonates.