Initial respiratory management in preterm infants and bronchopulmonary dysplasia
Clinics
;
66(5): 823-827, 2011. graf, tab
Article
in English
| LILACS
| ID: lil-593847
ABSTRACT
BACKGROUND:
Ventilator injury has been implicated in the pathogenesis of bronchopulmonary dysplasia. Avoiding invasive ventilation could reduce lung injury, and early respiratory management may affect pulmonary outcomes.OBJECTIVE:
To analyze the effect of initial respiratory support on survival without bronchopulmonary dysplasia at a gestational age of 36 weeks. DESIGN/METHODS:
A prospective 3-year observational study. Preterm infants of <32 weeks gestational age were classified into 4 groups according to the support needed during the first 2 hours of life room air, nasal continuous positive airway pressure, intubation/surfactant/extubation and prolonged mechanical ventilation (defined as needing mechanical ventilation for more than 2 hours).RESULTS:
Of the 329 eligible patients, a total of 49 percent did not need intubation, and 68.4 percent did not require prolonged mechanical ventilation. At a gestational age of 26 weeks, there was a significant correlation between survival without bronchopulmonary dysplasia and initial respiratory support. Preterm infants requiring mechanical ventilation showed a higher risk of death and bronchopulmonary dysplasia. After controlling for gestational age, antenatal corticosteroid use, maternal preeclampsia and chorioamnionitis, the survival rate without bronchopulmonary dysplasia remained significantly lower in the mechanically ventilated group.CONCLUSIONS:
In our population, the need for more than 2 hours of mechanical ventilation predicted the development of bronchopulmonary dysplasia in preterm infants with a gestational age >26 weeks (sensitivity =89.5 percent and specificity = 67 percent). The need for prolonged mechanical ventilation could be an early marker for the development of bronchopulmonary dysplasia. This finding could help identify a target population with a high risk of chronic lung disease. Future research is needed to determine other strategies to prevent bronchopulmonary dysplasia in this high-risk group of patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Respiration, Artificial
/
Bronchopulmonary Dysplasia
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Male
/
Infant, Newborn
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2011
Type:
Article
Affiliation country:
Spain
Institution/Affiliation country:
Universitário Gregorio Maranon/ES
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