title: Nasal CPAP (Infant Flow) applied at birth in extremely low birth weight newborns.
abstract: OBJECTIVE
  Evaluation of nasal CPAP (Infant Flow) as a ventilatory support, applied at birth in spontaneously breathing, extremely low birth weight newborns (ELBW).
  
  
  METHODS
  Retrospective analysis of the clinical course of respiratory distress syndrome (RDS) in 97 ELBW, who needed ventilatory support. In all patients the noninvasive ventilatory support was introduced within the first minute of life.
  
  
  RESULTS
  Among all analyzed newborns, 37.1% of patients were not intubated during hospitalization. Moreover, another 10.3% patients were intubated only due to surfactant administration according to the INSURE method and after 2-3 minutes of invasive ventilation they were switched to n-CPAP. Nearly half (47.4%) of all evaluated ELBW newborns who needed ventilatory support avoided mechanical ventilation. We found the frequency of bronchopulmonary dysplasia in 97 analyzed patients markedly lower when compared to data presented in literature (19% vs 34%; p=0.026).
  
  
  CONCLUSIONS
  We suggest that starting ventilatory support with the n-CPAP from the first minute of life is a safe and effective strategy in extremely low birth weight infants. It also reduces the costs of treatment, associated with surfactant administration.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Nowicka
authors.affiliation: Klinika Neonatologii UJ CM, Kopernika 23, 31-501 Kraków, ryszard@lauterbach.pl.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Lauterbach