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Changes in Respiratory Support of Preterm Infants in the Last Decade: Are We Improving?
MedLine Citation:
PMID:  22222256     Owner:  NLM     Status:  Publisher    
Background: Ventilator-induced lung injury has been recognized as a major contributing factor for bronchopulmonary dysplasia (BPD) in preterm infants. In the last decade, focus has shifted towards a more gentle respiratory approach. Aim: To evaluate whether guideline changes in respiratory management in the delivery room and the unit improved the incidence of BPD in very preterm infants. Methods: Three cohorts of infants <30 weeks of gestation, born at the Leiden University Medical Center in the Netherlands in 1996-1997 (cohort '96), 2003-2004 (cohort '03) and 2008-2009 (cohort '08), were compared retrospectively. The major change was increasing use of continuous positive airway pressure in time, and monitoring the tidal volume during mechanical ventilation in cohort '08. The primary outcome was BPD at 36 weeks. Results: The incidence of BPD did not change from 47% in cohort '96 to 55% in cohort '03 (n.s.), but decreased significantly to 37% in cohort '08 (cohort '96 vs. '08 and cohort '03 vs. '08: p < 0.01). We observed the same effect when only moderate and severe BPD were counted with 27% in cohort '96, 31% in cohort '03 and 14% in '08 (cohort '96 vs. '03: p = n.s., cohort '96 vs. '08: p < 0.01, cohort '03 vs. '08: p < 0.05). The mortality rate was not significantly different between the three cohorts. Conclusion: The incidence of BPD in our cohort of preterm infants has decreased during the last decade and could be due to the changes in respiratory management.
E E M Mulder; E Lopriore; M Rijken; F J Walther; A B Te Pas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-04
Journal Detail:
Title:  Neonatology     Volume:  101     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  247-253     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
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