Neonatal care of very‐low‐birthweight infants in special‐care units and neonatal intensive‐care units in Stockholm. Early nasal continuous positive airway pressure versus mechanical ventilation: gains and losses

摘要: Very-low-birthweight (VLBW) infants are usually intubated at birth and mechanically ventilated neonatal intensive-care units (NICUs). The objectives of this study were to evaluate the use early nasal continuous positive airway pressure (NCPAP) in a regional cohort determine what extent VLBW need transfer NICU from special-care (SCUs) that primarily NCPAP for respiratory care. We compared outcome SCUs NICUs Stockholm County, Sweden, 1988 1993. All with birthweights less than 1501 g included (n = 687). Fifty-nine per cent (400/687) supported using only supplemental oxygen or NCPAP. Of these, 170 (25%) received 230 (34%) by A total 350 (51%) these infants, 120 later required mechanical ventilation. Only 167 (24%) ventilation beginning. Failure was significantly associated presence distress syndrome. 161/412 (39%) transferred NICUs. ≤ 26 weeks' gestation > weeks, 71% 34% transferred, respectively. Total mortality 16%. transfers 20% an overall SCU 9% 15%, incidence intraventricular haemorrhage (IVH), grade III—IV 8%, periventricular leucomalacia (PVL) I—IV 7%, retinopathy prematurity (ROP) requiring cryotherapy 4.3% chronic lung disease (CLD) 14%. There significant differences IVH, PVL, CLD ROP between matched gestational age groups. In conclusion, 27 weeks more may often be adequately cared without However, should tertiary-care centres preferably before birth, because they will require