The Effect of Initial Mode of Respiratory Support on Bronchopulmonary Dysplasia in Extremely Low Birth Weight Preterm Infants
Abstract
Objectives: Despite improvements in neonatal care and survival of preterm infants, the incidence of bronchopulmonary dysplasia (BPD) is not decreasing. The aim of this study was to evaluate the impact of initial mode of respiratory support on BPD in extremely low birth weight (ELBW) infants.
Materials and Methods: ELBW infants admitted to neonatal intensive care unit were analyzed retrospectively between 2014 and 2017. The effects of initial respiratory support options and morbidities on BPD were evaluated between infants who developed BPD or not.
Results: Total 101 infants were evaluated, and 68 were included. For those whose incidence of BPD was 46%, the mean gestational age and birth weight were 27.8±1.8 weeks and 814±118 g, respectively. Patients with BPD (n=31) had a lower mean gestational age and birth weight, higher rates of necrotizing enterocolitis and retinopathy of prematurity (p<0.001, p=0.012, p=0.024, and p=0.018, respectively). Requirement of surfactant and need for invasive respiratory support initially after birth were found to be major risk factors for BPD. The duration of invasive ventilation after birth was longer in patients with BPD (p=0.034). BPD or death occurred in 66 of 101 infants. Infants received non-invasive respiratory support after birth had a lower risk for BPD, and BPD or death.
Conclusion: To prevent the development of BPD in ELBW infants, the respiratory support should be non-invasive after birth, and if the infant is intubated, duration of invasive respiratory support should be shortened for less than 3 days.
Keywords
Preterm, Infant, Bronchopulmonary Dysplasia, Extremely Low Birth Weight, Respiratory
Ethical Statement
Ethical approval was obtained from the Ethics Committee of Ankara University Faculty of Medicine with number 18-1212-18.
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