The Effect of Initial Management of Ventilation on the Incidence of Bronchopulmonary Dysplasia and Other Morbidities in Neonates Born at 24th–27th Weeks of Gestation at Clinic of Neonatology Slovak University Hospital Nove Zamky
Authors:
K. Demová; G. Magyarová; A. Bystrická
Authors‘ workplace:
Novorodenecká klinika FNsP, Nové Zámky
prednosta doc. MUDr. F. Bauer, PhD.
Published in:
Čes-slov Pediat 2010; 65 (9): 503-509.
Category:
Original Papers
Overview
Objective:
Evaluation of the incidence of bronchopulmonary dysplasia (BPD) and other comorbidities on the basis of initial ventilation management in the delivery room.
Methods:
Retrospective analysis of data from newborns born at Clinic of Neonatology University Hospital Nove Zamky, at 24th–27th weeks of gestation, from birth until discharge, during the period from 01. 01. 2005 to 31. 12. 2009. Patients were infants who were in the delivery room initially intubated and prophylactic surfactant was administered followed by N-CPAP (nasal continuous positive pressure in pulmonary passages) and babies who after surfactant administration continued on mechanical ventilation. In addition, the incidence of various types of BPD (classification according to NICHD, National Institute of Child Health and Human Development), comorbidities, length of hospitalization, and administration of postnatal steroids were observed in both groups.
Results:
The results of our retrospective analysis showed significantly lower incidence of mild forms of BPD in the group of newborns with gestation 24+0 to 27+6 weeks initially stabilized by early administration of surfactant and N-CPAP compared with newborn stabilized by early surfactant administration followed by mechanical ventilation (25% vs. 70%; p=0.001). The incidence of secondary forms of BPD was lower in group N-CPAP compared with MV (5% vs. 12.5%, p=0.361).
Conclusion:
Immediate extubation after surfactant administration to N-CPAP in neonates with gestation 24+0 to 27+6 weeks has shown decrease in the incidence of BPD, and other comorbidities as well as in shortening the length of hospitalization.
Key words:
delivery room, ELBWI (extremely immature newborns), resuscitation, CPAP, intubation, surfactant
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2010 Issue 9
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