title: Outcome of very low birthweight infants after introducing a new standard regime with the early use of nasal CPAP.
abstract: In this paper, a retrospective study was performed to find out whether the introduction of early nasal continuous positive airway pressure (nCPAP) as a new standard regime of very low birthweight infants will lead to a decreasing tracheal intubation and ventilation rate, as well as to a lower incidence of bronchopulmonary dysplasia in a tertiary-level perinatal centre. Ninety-three infants (study group) with early nCPAP as the first respiratory support were compared to 63 infants (historical control group) born before the use of early nCPAP. No statistically significant differences were found in the baseline characteristics. The main results of the study include reduced intubation mainly in infants with a birthweight <1,000 g (study group): 58% vs. 81% (p < 0.05). The mean duration of ventilation was 248 h (control group) vs. 128 h (study group) (p < 0.001) and 437 h vs. 198 h in infants <1,000 g (p < 0.001). There was significantly reduced incidence of bronchopulmonary dysplasia from 55% to 18% for all surviving infants (p < 0.001), and for infants <1,000 g, it was 90% vs. 30% (p < 0.001). No significant differences for other outcome criteria were noted, but a significant reduction in the use of central i.v. lines, fluids, drugs, volume expansion, sedation, catecholamines, surfactant, steroids and buffer, as well as antibiotics, was observed (p < 0.05). Therefore, we can conclude that early nCPAP is an easy-to-use and safe procedure for very low birthweight infants to treat respiratory distress.
authors.affiliation: Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Greifswald, Soldmannstrasse 15, 17475, Greifswald, Germany.
authors.forename: Ruth-Maria
authors.initials: RM
authors.lastname: Miksch
authors.forename: Sven
authors.initials: S
authors.lastname: Armbrust
authors.forename: Jens
authors.initials: J
authors.lastname: Pahnke
authors.forename: Christoph
authors.initials: C
authors.lastname: Fusch
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies