Respiratory support of preterm neonatesin delivery room

• Khienas V.
• Aleksandrovich Yuriy S.
• Pshenisnov Konstantin V.
• Prometnoy D.V.
• Pilypiene I.
• Koltsov M.A.

Abstract

This article aimsto evaluate the effectiveness of respiratory support and to analyse the outcomes in preterm infants depending on the applied methods of artificial lung ventilation (non-invasive and invasive AVL).

Material and methods. The study includes 83 preterm neonates born in Vilnius Maternity Hospital and Vilnius University Hospital 'Santariskiu Klinikos', Lithuania, since 2013 to 2015. Median gestationalage 32 (28 to 35) weeks with birth weight 1830 (1040 to 2420) g. Depending on body weight, all babies were divided into the groups: group 1 (n=18) - preterm neonates with extremely low body weight at birth (under 1000 g); group 2 (n=17) - babies with very low body weight (1000 to 1499 g); group 3 (n=48) - babies with low body weight at birth (1500 g and more).

Results. Invasive artificial lung ventilation (iAVL) immediately after birth was applied only in group I (27.8% of patients in this group), including 4 (22.2%) patients ventilated after surfactant administration. In groups 2 and 3, iAVL was not used in the delivery room. After admission to ICU, fifteen more babies required tracheal intubation and iAVL (18.1% of all patients), after earlyn CPAP therapy respiratory support in the delivery room. Totally 11 (61.1%) patients required AVL at ICU in group 1, while in group 2 and 3 - 4 (23.5%) and 6 (12.5%) correspondingly (р<0.05). It was established that in group 1 and 2 intraventricular haemorrhageswere diagnosed substantially more often than in group 3 patients (р_2,3=0,01; р_1,3=0,00). Application of invasive ventilation is a risk factor for IVH in babies with extremely low body weight at birth.

Conclusion. Early application of non-invasive respiratory support techniques (nasal CPAP) in delivery room prevents tracheal intubation and invasive artificial lung ventilation in 40% of neonates with very low and low body weight at birth.

Keywords:preterm neonates, respiratory support, non-invasive AVL, nCPAP, outcome

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