Article Text
Abstract
Increasing incidence of BPD leads to frequent hospital readmissions in later life.
Aim We investigated whether nCPAP used in unstable infants with BPD affects later prognosis.
Methods 45 VLBW infants with BPD (O2>28 days, + chest X-ray) comprised the study group. Of these, 27 (group A: BW: 977±163 gr, GA: 27.5±1.4 wks), were on nCPAP (diuretics and O2 when necessary) for 18 days after the 10th day of life (median 18, range 9–34). The control group (group B) comprised 18 newborns (BW: 1023±218 gr, GA: 28±2.1 wks) whose conservative treatment included theophylline (IV/PO), salbutamol and cortisone (IV/nebulizer), besides O2 and diuretics. These infants were either not in nCPAP after the 10th day of life, or were administered nCPAP<5 days. 25 group A (A1) infants and 15 group B (B1) were followed for 2 years for lower respiratory tract infections. 22 group A (A2) infants and 12 group B (B2) were followed from 3 up to 5 years of age.
Results In the first year of life, 60% of group A1 infants were respiratory disease free in contrast to 20% of group B1 (p<0.05). In the second year, 68% of group A1 infants were respiratory disease free compared to 26.6% of group B1(p<0.05). Between 3 and 5 years, 54% of group A (A2) infants were respiratory disease free and 33% of group B (B2) (p>0.05).
Conclusions Use of nCPAP in infants with BPD appears to positively influence late prognosis, perhaps due to stabilization of the alveolus and thoracic cage.