Aim To evaluate the clinical outcomes of very-low-birth-weight infants received non-invasive ventilation at delivery room (DR) and NICU.
Methods This prospective cohort study included infants born before 29 weeks’, and infants born at 29–30 weeks’ who didn’t receive antenatal steroid (ANS) from January-2009 to December 2011. During resuscitation, stabilization and transport infants were ventilated with a T-piece. All received 100 mg/kg surfactant. If respiratory drive was present, infants were extubated to nasal CPAP(NCPAP). The need for MV within the first 3-days, neonatal morbidities, mortality, and duration of hospitalization were assessed.
Results Eighty infants were evaluated. Mean gestational age(GA) and the mean birth weight(BW) of infants were 27.0±2.1 weeks, and 936.5±299.1 g, respectively. ANS was given to 27.5% of the pregnancies. The presence of PPROM and chorioamnionitis were 57.5% and 34%, respectively. Twenty-three (28.7%) infants could not be extubated at the DR, and mean GA and BW were lower than the infants who could extubated. Ten(17.5%) of 57 infants who were on NCPAP initially needed MV during their first 3-days. There wasn’t any case with air leak. The incidence of pulmonary hemorrhage, PDA, NEC, İVH, BPD, ROP and mortality were 6.2%, 26.2%, 20%, 13.8%, 10%, 10% and 38.7%, respectively. The duration of respiratory support was 1–720 hours(median: 29 hours). Mean duration of hospitalization was 34.9±28.4 days.
Conclusion Our study demonstrated that NCPAP is an effective non-invasive ventilatory strategy. It didn’t increase the risk of air leak. The incidences of BPD and ROP in our series were lower than reported in ‘NICHD Neonatal Research Network’ data.
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