Abstract
Bronchopulmonary dysplasia (BPD) remains a significant complication associated with positive pressure mechanical ventilation of newborn infants. All NICU admissions during 1982 and 1983 were studied to compare the incidence of BPD and to identify differences with respect to, recognized risk factors. In 1983 an effort was made to use lower peak inflation pressures (PIP) and less IV fluid in initial management. RDS was present in 77/355 infants in 1982 and 71/354 in 1983 with no difference in disease severity. In 1982, 15/77 (19.5%) of infants with RDS developed clinical BPD (requiring supplemental oxygen for >28d) compared with 5/71 (7%) in 1983 (p<.05). In the 20 infants with clinical BPD, there was no significant difference between 1982 and 1983 with respect to gestational age, radiographic severity of initial lung disease, presence of a clinically significant PDA, or maximum FiO2. Mean PIP in 1982 and 28.6±11SM cmH2O vs 17.7±1.9 cmH2O for 1983 (p<.02). Weight loss/birth weight × 100 at days 3 and 10 were 9.19% and 10.02% (1982) vs 16.75% and 18.2% ((p<.03, p<.02). In summary, a lower incidence of BPD was associated with lower peak inflation pressure and greater weight loss in early life suggesting that judicious use of positive pressure ventilation and careful fluid management may reduce the occurrence of BPD.
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