Predicting outcome in neonatal hypoxic respiratory failure with the score for neonatal acute physiology (SNAP) and highest oxygen index (OI) in the first 24 hours of admission.
OBJECTIVE
To determine the clinical utility of SNAP score versus the highest oxygen index (OI) in first 24 hours of admission in predicting outcome of HRF.


METHODS
All admissions (1991 to 1999) > or =36 weeks gestation, ventilated for > or =12 hours with FiO(2)> or =0.50, without congenital anomalies were reviewed. Primary outcome measure was survival (without ECMO) versus ECMO and/or death.


RESULTS
From 184 infants with HRF, 148 survived (without ECMO) versus 36 died and/or received ECMO. SNAP score and highest OI were similar in predicting outcome of HRF (area under ROC curve: 0.813+/-0.037 versus 0.814+/-0.041; P=0.72). Death and/or ECMO requirement were best predicted by a SNAP score of 19 (Sensitivity 75.0%, Specificity 71%) or an OI of 28 (Sensitivity 75.0%, Specificity 76.4%).


CONCLUSIONS
Although both, the SNAP score and highest OI, are useful and similar in predicting outcome of HRF, OI is preferable because of its ease of use. We believe the predictive value of these parameters should be evaluated in a multicenter setting.
Kumar
Deepak
D
Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH, USA.
Super
Dennis M
DM
Fajardo
Rudolph A
RA
Stork
Eileen E
EE
Moore
John J
JJ
Saker
Firas A
FA
D000403:Airway Resistance; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood*; D012372:ROC Curve; D012131:Respiratory Insufficiency / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D010100:Oxygen