Analysis Of Risk Factors For Failure Of Infants With Severe Bronchiolitis Treated With Continuous Positive Airway Pressure

Objective:To investigate the risk factors for the failure of continuous positive airway pressure（CPAP）in the treatment of infant bronchiolitis.Methods:The clinical data of 310 hospitalized children with bronchiolitis treated with CPAP from 1 to 12 months of age were retrospectively analyzed,and the clinical characteristics of the successful group（270 cases）and the failed group（40 cases）of CPAP were compared.Multivariate logistic regression analysis was used to explore predictors of CPAP treatment failure.Results:Multivariate logistic regression analysis showed that no improvement of the oxygenation index（arterial oxygen pressure/inhaled oxygen concentrations,PaO₂/FiO₂,P/F）after 2 hours of CPAP treatment（OR=34.084）,the third-generation pediatric death risk score and pediatric critical case score（PRISM-Ⅲ）≥10（OR=13.905）,complicated with atelectasis（OR=12.080）,combined with cardiac insufficiency（OR=7.741）)were the risk factors for failure of CPAP to treat bronchiolitis（P<0.05）.No improvement of the P/F after 2 hours of CPAP treatment indicated that the area under the operating characteristic curve was 0.793,and the sensitivity and specificity were 70.3%and 82.4%,respectively（the cutoff value was 203）.Conclusion:No improvement of the P/F after 2 hours of CPAP treatment,PRISMⅢscore≥10,complicated with atelectasis and combined with cardiac insufficiency were risk factors for CPAP treatment failure.