Risk Factors Associated With Early-Selective Bubble Nasal Continuous Positive Airway Pressure and Surfactant Failure in Premature Infants With Respiratory Distress Syndrome
Bibliographic record
Abstract
Background: The aim of the study was to identify significant risk factors associated with early-selective bubble nasal continuous positive airway pressure (BnCPAP) and surfactant failure in preterm infants with respiratory distress syndrome (RDS). Methods: This was a retrospective cohort study of 344 premature infants with RDS born at the Hospital Universitario de Santander, Bucaramanga, Colombia, between 2006 and 2015. All infants were required to have clinical evidence of progressive respiratory failure, FiO 2 ≥ 0.4, and exposure to BnCPAP and surfactant with the INSURE method as initial management for RDS. The primary outcome was the failure of early-selective BnCPAP and INSURE. The incidence of failure was estimated as a cumulative incidence and incidence density ratio. The strength of association with failure was estimated by binomial regression, Kaplan-Meier survival curves, and Cox's regression adjusting for birth weight and gestational age (GA). Results: Early-selective BnCPAP and INSURE failure occurred in 53/344 patients: a cumulative incidence of failure of 14.9% and an incidence density rate of 3.9/1,000 h of BnCPAP exposure. Risk factors associated with failure were: GA < 28 weeks (relative risk (RR) = 2.62, 95% confidence interval (CI): 1.39 - 4.94) and need for resuscitation with positive pressure ventilation (RR = 1.97, 95% CI: 1.09 - 3.54). Additionally, failure was associated with a higher risk of severe intraventricular hemorrhage and death. Conclusion: GA < 28 weeks and need for positive pressure ventilation during resuscitation were associated with failure of early-selective BnCPAP and INSURE. Early-selective mechanical ventilation and surfactant therapy should be considered in this subgroup of patients. Int J Clin Pediatr. 2024;13(2):41-47 doi: https://doi.org/10.14740/ijcp519
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".