Impact of hypothermia on implementation of CPAP for neonatal respiratory distress syndrome in a low-resource setting

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dc.citation.articleNumbere0194144en_US
dc.citation.issueNumber3en_US
dc.citation.journalTitlePLoS ONEen_US
dc.citation.volumeNumber13en_US
dc.contributor.authorCarns, Jenniferen_US
dc.contributor.authorKawaza, Kondwanien_US
dc.contributor.authorQuinn, M.K.en_US
dc.contributor.authorMiao, Yinsenen_US
dc.contributor.authorGuerra, Rudyen_US
dc.contributor.authorMolyneux, Elizabethen_US
dc.contributor.authorOden, Mariaen_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.orgBioengineeringen_US
dc.contributor.orgStatisticsen_US
dc.date.accessioned2018-07-16T17:48:55Zen_US
dc.date.available2018-07-16T17:48:55Zen_US
dc.date.issued2018en_US
dc.description.abstractBackground: Neonatal hypothermia is widely associated with increased risks of morbidity and mortality, but remains a pervasive global problem. No studies have examined the impact of hypothermia on outcomes for preterm infants treated with CPAP for respiratory distress syndrome (RDS). Methods: This retrospective analysis assessed the impact of hypothermia on outcomes of 65 neonates diagnosed with RDS and treated with either nasal oxygen (N = 17) or CPAP (N = 48) in a low-resource setting. A classification tree approach was used to develop a model predicting survival for subjects diagnosed with RDS. Findings: Survival to discharge was accurately predicted based on three variables: mean temperature, treatment modality, and mean respiratory rate. None of the 23 neonates with a mean temperature during treatment below 35.8°C survived to discharge, regardless of treatment modality. Among neonates with a mean temperature exceeding 35.8°C, the survival rate was 100% for the 31 neonates treated with CPAP and 36.4% for the 11 neonates treated with nasal oxygen (p<0.001). For neonates treated with CPAP, outcomes were poor if more than 50% of measured temperatures indicated hypothermia (5.6% survival). In contrast, all 30 neonates treated with CPAP and with more than 50% of temperature measurements above 35.8°C survived to discharge, regardless of initial temperature. Conclusion: The results of our study suggest that successful implementation of CPAP to treat RDS in low-resource settings will require aggressive action to prevent persistent hypothermia. However, our results show that even babies who are initially cold can do well on CPAP with proper management of hypothermia.en_US
dc.identifier.citationCarns, Jennifer, Kawaza, Kondwani, Quinn, M.K., et al.. "Impact of hypothermia on implementation of CPAP for neonatal respiratory distress syndrome in a low-resource setting." <i>PLoS ONE,</i> 13, no. 3 (2018) Public Library of Science: https://doi.org/10.1371/journal.pone.0194144.en_US
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0194144en_US
dc.identifier.urihttps://hdl.handle.net/1911/102422en_US
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.rightsThis is an open access article distributed under the terms of theﾠCreative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.titleImpact of hypothermia on implementation of CPAP for neonatal respiratory distress syndrome in a low-resource settingen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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