153 The Influence of NCPAP on the Prognosis of VLBW Newborns with BPD.

Abstract

Background Treatment of bronchopulmonary dysplasia (BPD) includes oxygen, diuretics, xanthines, salbutamol and cortisone. These newborns usually present with respiratory problems and often require readmission to hospital during their first two years. Aim We asked if nCPAP treatment affects the prognosis of VLBW newborns with BPD. Methods 45 VLBW infants with BPD (O2>28 days, + chest x-ray) were included in the study. 27 of these, [group A: mean BW (SD) 977 (163) gr. mean GA (SD) 27.5 (1.4) weeks], were treated with nCPAP for 18 (median, range 9–34) days after the 10th day of life. They were also administered diuretics and oxygen when needed. The control (group B) consisted of 18 newborns [mean BW (SD) 1023 (218) gr. mean GA (SD) 28 (2.1) weeks], their conservative treatment, besides O2 and diuretics, included theophylline IV or PO, salbutamol and cortisone IV or in nebulizer. These infants were either not in nCPAP after the 10th day of life, or were administered nCPAP<5 days. 25 newborns from group A (A1) and 15 from group B (B1) were followed for 2 years for lower respiratory tract infections. Results Group A were in full enteral feeding 12 (mean) days earlier than the comparison group (P=0.023), needed O2 3.5 fewer days (NS) and remained in hospital 8 days fewer (NS). At 12 months, 15 /25 infants of group A1 were free of respiratory problems (60%) compared to only 3 /15 infants of group B1 (20%), (P<0.05). At 24 months, 17 of group A1 were free of respiratory problems (68%), compared to only 4 of group B1 (26.6%), (P<0.05). Conclusions the use of nCPAP treatment in VLBW infants with BPD seems to positively influence their early and late prognosis. Nasal CPAP stabilizes the alveolus and thoracic cage and this may be the reason for a better prognosis.