Aim To evaluate the non-invasive ventilatory support in micro-premature infants who are at the limits of viability.
Methods This prospective cohort study from January-2009 to December 2011 included infants born before 26 weeks’. During resuscitation, stabilisation and transport infants were ventilated with a T-piece resuscitator, and all received prophylactic surfactant at a dose of 100 mg/kg. If respiratory drive was present, infants were extubated to NCPAP. The demographic and clinical features of the infants were assessed.
Results Twenty-four infants born during the study period. Antenatal steroid rate was 16.7%. Mean gestational age(GA) and birth weight(BW) were 24.3±0.9 weeks, and 660.2±125.5 g, respectively. The presence of premature rupture of membranes and chorioamnionitis rate was 54%. Only five(21%) of 24 infants could be extubated to NCPAP, and three of these five were intubated in first 3-days. Only two(8.3%) infants succeeded on NCPAP, and the GAs’ were 24.6 and 25.1 weeks, the BWs’ were 1010 and 730 g. The rate of NEC, PDA, İVH and pulmonary hemorrhage were 29%, 36%, 36% and 21%, respectively in infants who survived more than 2 days. The overall mortality rate was 92%, the duration of hospitalization was between one and 137 days.
Conclusion In our study, it has been seen that NCPAP may not be an effective ventilation strategy in premature infants who are at the limits of viability. The high proportion of chorioamnionitis in this group may affect the ventilation and the following problems. These babies are needed to be care at very special settings.