Prognostic value of clinical and radiological status on day 28 of life for subsequent course in very low birthweight (< 1,500g) babies with bronchopulmonary dysplasia

Abstract

To test the hypothesis that the short-term (approximately 6 months) course of babies with bronchopulmonary dysplasia (BPD) could be predicted from the clinical and radiological status on day 28 of life, we retrospectively examined the medical records of 79 infants born between 1985 and 1988 who required supplemental oxygen and/or ventilatory support on day 28. Chest roentgenographs taken close to day 28 (+/- 7 days) were scored on a scale of 0-10. Four babies died from causes not related to BPD. Four of the remaining 75 died from BPD, and the rest are alive. Forty-six of 71 were weaned from supplementary oxygen by 37 weeks corrected gestational age, and only 13/71 remained on supplemental oxygen after 40 weeks gestational age. To determine which variables contributed most to the outcome, defined as total days on supplemental oxygen, a multiple regression analysis was performed, including only those variables the tolerance of which exceeded 0.7 (sex, FiO2, ventilatory mode, and infectious status). FiO2 and ventilatory mode together predicted 15% of the variability in outcome, so that a high FiO2 and ventilator dependence on day 28 of life were highly correlated with a prolonged need for supplemental oxygen (F = 4.28, P < 0.05).

Respiratory severity score on day of life 30 is predictive of mortality and the length of mechanical ventilation in premature infants with protracted ventilation

“…Eight of their 79 infants died (10.1%), although these infants were more mature (27 weeks), had greater birth weight (900 g) and their lung disease was not as severe as patients in our study. 12 They found that both F i O 2 and peak inspiratory pressure highly correlated with the risk for death. Overstreet et al 1 reported a higher mortality rate, 23% (33/144) for infants ventilated at 1 month of age, and found that MAP at 1 month was the best predictor of survival.…”

Comparison of a Closed (Trach Care MAC) With an Open Endotracheal Suction System in Small Premature Infants

“…20 According to clinical indications, infants with BPD were given dexamethasone sodium phosphate (0.5 mg/kg per day intravenously given in two doses every 12 hours) for 3 days, followed by dosage tapering. Throughout the study period, no infant received dexamethasone before 7 days of age.…”

Purulence and Gram-Negative Bacilli in Tracheal Aspirates of Mechanically Ventilated Very Low Birth Weight Infants

“…19 BPD was diagnosed clinically in infants who presented signs of respiratory failure, were on mechanical ventilation longer than 2 weeks, and were still treated with oxygen at 28 days of life. 20 Severity of BPD was defined by the need for treatment with oxygen at 36 weeks postconceptional age (PCA) and at the time of discharge from the hospital. 21,22 According to clinical needs, BPD infants were given dexamethasone sodium phosphate iv (0.5 mg/kg per day given in two doses every 12 hours) for 3 days, followed by dosage tapering.…”