Prevalence and risk factors of bronchopulmonary dysphasia in neonates who requiring mechanical ventilation.

ABSTRACT

To find the prevalence and risk factors of bronchopulmonary dysphasia (BPD) in neonates requiring ventilator support, a retrospective study was performed of neonates admitted to the Pediatric Intensive Care Unit, Department of Pediatrics, Siriraj Hospital during January 1990-January 1992. Of the 195 neonates who were admitted, sixty-eight died before the age of 28 days. The data was analyzed from 107 neonates; 48.6% of the infants weighed less than 1,500 gm. According to Bancalari’s criteria, forty infants (37.4%) suffered from BPD. The mean birth weight and gestational age in the non BPD group was statistically significant higher than the BPD group (1,783 gm, 37 wk vs 1,486 gm, 30 wk). From this study, the incidence of prematurely, patent ducts arterioles, the amount and duration of oxygen therapy, peak inspiratory pressure (PIP), mean airway pressure (MAP) and amounts of fluid therapy during the first 7 postnatal dais in the BPD group are all statistically higher than in the non BPD group. The etiology of BPD may be multifactorial, but prematurely and oxygen toxicity seem to be the two most important factors. Prevention of prematurely, administration of artificial surfactant as an initial therapy for respiratory distress syndrome, the avoidance of barotrauma by using the lowest PIP to maintain PaO2, PaCO2, and the implementation of transcutaneous oxygen saturation monitoring, may decrease the incidence of BPD in these high risk neonates.