[Early treatment with nasal continuous positive airway pressure and "minimal handling". Early and late prognosis in children with birth weight under 1,501 g].
During 1988 and 1989 a regional cohort of 81 infants with birth weights of less than 1501 g were treated with oxygen (n = 11), early continuous positive airway pressure (CPAP) (n = 68) or mechanical ventilation from birth (n = 2). We used an easily applicable lightweight CPAP system with nasal prongs and a gas jet supplemented with ventilator treatment if necessary, but with conservative criteria for ventilator treatment with tolerance of high PCO2. A total of 65 infants (80%) survived to discharge, 61 of whom were supported solely with CPAP or oxygen. Nineteen infants (26%) developed periventricular-intraventricular haemorrhage, but only four survivors (6%) developed prognostically significant bleedings of grade 2-4. No survivors had bronchopulmonary dysplasia. Follow-up at 1.5-5 years of age revealed definite disabilities in seven (11%). The results suggest that treatment by early CPAP with nasal prongs with tolerance of high PCO2 may be effective and lenient in most infants of more than 25 weeks' gestation.
Kamper
J
J
Odense Universitetshospital, børneafdeling H og radiologisk afdeling.
Wulff
K
K
Larsen
C O
CO
Lindequist
S
S
D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
Tidlig behandling med nasalt kontinuerligt overtryk i luftvejene og "minimal handling". Tidlig- og senprognose hos børn med fødselsvoegt < 1.501 g.