J Korean Pediatr Soc.  2003 Nov;46(11):1073-1079.

A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years

• Jung BK
• Kim YJ
• Lee SG

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.

Keyword

Low birth weight infant; Endotracheal intubation; Assisted ventilation; Continuous positive airway pressure

MeSH Terms

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*