Complications of the post-ventilation period in preterm newborn infants
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Abstract
Mechanical ventilation is a life-saving method of respiratory support for preterm newborn infants with severe respiratory failure; however, infants requiring invasive ventilation remain at increased risk of pulmonary and extrapulmonary morbidity. The aim of this study was to assess the frequency of major complications during the post-ventilation period in preterm newborn infants and to compare outcomes between infants who required mechanical ventilation and those managed without invasive ventilation. The study included 90 newborn infants divided into two groups: Group 1 comprised 70 infants who received mechanical ventilation, while Group 2 included 20 infants who did not require mechanical ventilation and served as the comparison group. Bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), echocardiographically confirmed pulmonary hypertension and periventricular leukomalacia (PVL) were evaluated. BPD occurred in 17 infants (24.3 %) in Group 1 and in none of the infants in Group 2; this was the only difference that reached statistical significance (p = 0.010; risk difference 24.3 percentage points, 95 % CI 6.1–35.5). ROP was diagnosed in 13 infants (18.6 %) and 1 infant (5.0 %), respectively (p = 0.179); pulmonary hypertension was detected in 9 ventilated infants (12.9 %) and was absent in the comparison group (p = 0.199); PVL occurred in 5 infants (7.1 %) in Group 1 and in none of Group 2 (p = 0.583). All four complications were more frequent among ventilated infants and three occurred exclusively in that group, but with only 20 infants in the comparison group the three latter differences could not be confirmed statistically. The findings support lung-protective respiratory strategies and early transition to non-invasive respiratory support whenever clinically feasible.
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