A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years.
- Author:
Byun Kyung JUNG
1
;
Yeoung Ju KIM
;
Sang Geel LEE
Author Information
1. Department of Pediatrics, Fatima Hospital, Taegu, Korea. sgleeped@korea.com
- Publication Type:Original Article
- Keywords:
Low birth weight infant;
Endotracheal intubation;
Assisted ventilation;
Continuous positive airway pressure
- MeSH:
Continuous Positive Airway Pressure;
Gestational Age;
Humans;
Infant*;
Infant, Low Birth Weight;
Infant, Newborn;
Infant, Very Low Birth Weight*;
Intensive Care, Neonatal;
Intubation, Intratracheal;
Mortality;
Parturition;
Retrospective Studies;
Ventilation;
Ventilators, Mechanical*
- From:Journal of the Korean Pediatric Society
2003;46(11):1073-1079
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. METHODS: We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. RESULTS: Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. CONCLUSION: Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.
