Factors Associated with Nasal Intermittent Positive Pressure Ventilation Failure in Late Preterm and Term Infants with Respiratory Distress after Birth

Purpose We examined the factors associated with nasal intermittent positive pressure ventilation (NIPPV) failure in late preterm and term infants with respiratory distress after birth. Methods A retrospective cohort study was conducted on late preterm and term infants with respiratory distress after birth from January 2015 to December 2020. The medical records of 132 infants, who received NIPPV as primary respiratory therapy before 6 hours of age, were retrospectively examined. We excluded five neonates who were either transferred to another hospital (n=2) or presented with congenital anomalies (n=3). Results The remaining 127 neonates were divided into the NIPPV success group (n=82) and NIPPV failure group (n=45). NIPPV failure was associated with birth in a community hospital, the need for a surfactant, and a high maximum respiratory severity score (RSS ≥2.5) on the first day of life. In the subgroup analysis, NIPPV failure in late preterm infants was associated with a lower gestational age, birth in a community hospital, and an RSS ≥2.5 on the first day of life. In addition, NIPPV failure in term infants was associated with birth in a community hospital, the need for a surfactant, and an RSS ≥2.5 on the first day of life. Conclusion Birth in a community hospital, the need for a surfactant, and an RSS ≥2.5 on the first day of life were significant factors associated with NIPPV failure in late preterm and term infants.