Ventilatory pump failure in premature newborns.
OBJECTIVE
To determine the prevalence of ventilatory pump failure in premature (< 34 weeks gestation) infants.


METHODS
Prospective clinical evaluation of all neonatal intensive care unit (NICU) admissions over a 12 month period in a large, university affiliated hospital.


METHODS
A series of 421 consecutive inborn premature infant admissions to the NICU.


METHODS
Infants were followed for signs and symptoms of respiratory distress and monitored closely for evidence of respiratory failure requiring intubation and assisted ventilation. The indications for intubation and assisted ventilation were reviewed, and three such indications were considered clear manifestations of ventilatory pump failure, that is, delivery room resuscitation with CXR negative for evidence of parenchymal lung disease [DR/CXR-], hypercapnia (PaCO2 > 55 torr) [increases CO2], and apnea.


RESULTS
A total of 192 premature infants (47% of study sample) required intubation and assisted ventilation. Failure of the ventilatory pump to sustain ventilation (DR/CXR-, increases CO2, apnea) accounted for 70 of these 192 (36%) premature infants.


CONCLUSIONS
Ventilatory pump failure is a common clinical phenomenon in premature infants. Intensified research on the mechanisms and treatment of ventilatory pump failure might benefit a significant number of such newborns.
Watchko
J F
JF
Department of Pediatrics, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania 15213.
Balsan
M J
MJ
D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000628:therapy; D007363:Intensive Care Units, Neonatal; D007440:Intubation / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000453:epidemiology* / Q000628:therapy