Prevention of bronchopulmonary dysplasia by infants that have an increased risk for the development of the disease

Abstract

Methods: Investigating the combined effect of administering surfactant at delivery, antenatal steroid prophylaxis, reduced oxygen concentration and lowered pressure of mechanical ventilation, early weaning and extubation, as well as supplementation of vitamins A and C on the development of bronchopulmonary dysplasia of very low birth weight infants. Experimental subjects were 13 very low birth weight preterm infants, born between September 2007 and February 2008, selected as being at high risk of developing bronchopulmonary dysplasia on the basis of their IL-6 levels (obtained from tracheal aspirate and whole blood) taking CRP into consideration as well. These subjects were given the aforementioned treatment alternative to the one generally used and professionally recommended. Newborns with normal IL-6 levels in tracheal aspirate were considered the “normal” group and received the treatment traditionally recommended for premature babies. Results: 50% of the infants needed HFO ventilation (for 4 to 11 days). All infants needed synchronized intermittent mandatory ventilation (for 2 to 17 days). 17% of them also received continuous positive airway pressure treatment (for 2 to 7 days). The incidence of bronchopulmonary dysplasia was 16.66%. Conclusions: For very low birth weigh infants with risk for developing bronchopulmonary dysplasia the combined use of surfactant therapy, antenatal steroid prophylaxis, lowered oxygen saturation goals, early weaning and extubation, and A and C vitamin supplementation has resulted in decreased incidence of bronchopulmonary dysplasia.