Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks

Objectives: To evaluate the respiratory support strategy and its association with morbidity and mortality in preterm infants with Gestational Age (GA) ≤ 32 weeks, admitted between 2000 and 2008. Methods: Chart data from newborns with GA ≤ 32 weeks admitted to a tertiary Neonatal Intensive Care Uni...

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Main Authors: Sara Aguilar, Teresa Rodrigues, Margarida Albuquerque, Isabel Sampaio, Bruno Cardoso, Leonor Boto, Carlos Moniz, Graça Oliveira
Format: Article
Language:English
Published: Hygeia Press di Corridori Marinella 2013-03-01
Series:Journal of Pediatric and Neonatal Individualized Medicine
Subjects:
Online Access:https://www.jpnim.com/index.php/jpnim/article/view/39
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author Sara Aguilar
Teresa Rodrigues
Margarida Albuquerque
Isabel Sampaio
Bruno Cardoso
Leonor Boto
Carlos Moniz
Graça Oliveira
author_facet Sara Aguilar
Teresa Rodrigues
Margarida Albuquerque
Isabel Sampaio
Bruno Cardoso
Leonor Boto
Carlos Moniz
Graça Oliveira
author_sort Sara Aguilar
collection DOAJ
description Objectives: To evaluate the respiratory support strategy and its association with morbidity and mortality in preterm infants with Gestational Age (GA) ≤ 32 weeks, admitted between 2000 and 2008. Methods: Chart data from newborns with GA ≤ 32 weeks admitted to a tertiary Neonatal Intensive Care Unit between 2000-2008, were reviewed retrospectively. Newborns were divided into two groups according to the year of birth: Group 1 (2000-2004) and Group 2 (2005-2008). Each group of newborns was subdivided in subgroups according to their GA: 23-28 gestational weeks and 29-32 gestational weeks. Each group was compared in terms of ventilation and surfactant strategy, morbility and mortality. The statistical analysis was carried out with SPSS 21.0. Results: We included 499 newborns, 224 in Group 1 and 275 in Group 2. The mean GA, sex and birth weight were similar in both groups. The comparison of the two groups showed a statistically significant difference in the rate of invasive ventilation and surfactant strategy. The mortality before discharge rate was 17.4% for Group 1 and 13.5% for Group 2. The comparison of the subgroups, revealed a statistically higher incidence of INSURE strategy and noninvasive ventilation in newborns born after 2004, with reduction of the mortality rate in newborns with GA comprised between 29-32 weeks and reduction of pneumothorax, severe chronic lung disease and intraventricular hemorrhage in newborns with GA comprised between 23-28 weeks. Conclusion: There was a tendency towards non-invasive strategy and INSURE administration of surfactant over the years. Mortality and major morbidity decreased along with these changes in the therapeutic approach of the respiratory distress syndrome in preterm newborns.
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spelling doaj.art-d011e68c6edc4e00b38dd25370cb489d2022-12-22T01:47:33ZengHygeia Press di Corridori MarinellaJournal of Pediatric and Neonatal Individualized Medicine2281-06922013-03-0121414710.7363/02010328Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeksSara Aguilar0Teresa Rodrigues1Margarida Albuquerque2Isabel Sampaio3Bruno Cardoso4Leonor Boto5Carlos Moniz6Graça Oliveira7Centro Hospitalar Lisboa - Norte, Hospital de Santa MariaBiomathematics Laboratory, Faculty of Medicine, University of LisbonCentro Hospitalar Lisboa - Norte, Hospital de Santa MariaCentro Hospitalar Lisboa - Norte, Hospital de Santa MariaHospital de Santo Espírito - Hospital da Ilha TerceiraCentro Hospitalar Lisboa - Norte, Hospital de Santa MariaCentro Hospitalar Lisboa - Norte, Hospital de Santa MariaCentro Hospitalar Lisboa - Norte, Hospital de Santa MariaObjectives: To evaluate the respiratory support strategy and its association with morbidity and mortality in preterm infants with Gestational Age (GA) ≤ 32 weeks, admitted between 2000 and 2008. Methods: Chart data from newborns with GA ≤ 32 weeks admitted to a tertiary Neonatal Intensive Care Unit between 2000-2008, were reviewed retrospectively. Newborns were divided into two groups according to the year of birth: Group 1 (2000-2004) and Group 2 (2005-2008). Each group of newborns was subdivided in subgroups according to their GA: 23-28 gestational weeks and 29-32 gestational weeks. Each group was compared in terms of ventilation and surfactant strategy, morbility and mortality. The statistical analysis was carried out with SPSS 21.0. Results: We included 499 newborns, 224 in Group 1 and 275 in Group 2. The mean GA, sex and birth weight were similar in both groups. The comparison of the two groups showed a statistically significant difference in the rate of invasive ventilation and surfactant strategy. The mortality before discharge rate was 17.4% for Group 1 and 13.5% for Group 2. The comparison of the subgroups, revealed a statistically higher incidence of INSURE strategy and noninvasive ventilation in newborns born after 2004, with reduction of the mortality rate in newborns with GA comprised between 29-32 weeks and reduction of pneumothorax, severe chronic lung disease and intraventricular hemorrhage in newborns with GA comprised between 23-28 weeks. Conclusion: There was a tendency towards non-invasive strategy and INSURE administration of surfactant over the years. Mortality and major morbidity decreased along with these changes in the therapeutic approach of the respiratory distress syndrome in preterm newborns.https://www.jpnim.com/index.php/jpnim/article/view/39prematurityinvasive ventilationnoninvasive ventilationsurfactant therapymorbiditymortalityinsure strategy
spellingShingle Sara Aguilar
Teresa Rodrigues
Margarida Albuquerque
Isabel Sampaio
Bruno Cardoso
Leonor Boto
Carlos Moniz
Graça Oliveira
Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
Journal of Pediatric and Neonatal Individualized Medicine
prematurity
invasive ventilation
noninvasive ventilation
surfactant therapy
morbidity
mortality
insure strategy
title Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
title_full Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
title_fullStr Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
title_full_unstemmed Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
title_short Respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
title_sort respiratory support strategy in 499 preterm newborns with gestational age ≤ 32 weeks
topic prematurity
invasive ventilation
noninvasive ventilation
surfactant therapy
morbidity
mortality
insure strategy
url https://www.jpnim.com/index.php/jpnim/article/view/39
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AT isabelsampaio respiratorysupportstrategyin499pretermnewbornswithgestationalage32weeks
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