Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Ventilated with Continuous Positive Airway Pressure vs. Mechanical Ventilation
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Abstract
Objective
To compare continuous positive airway pressure (CPAP) vs. traditional mechanical ventilation (MV) at 24 h of age as predictors of neurodevelopmental (ND) outcomes in extremely low birth weight (ELBW) infants at 18–22 months corrected gestational age (CGA).
Methods
Infants ≤1000 g birth weight born from January 2000 through December 2006 at two hospitals at the Cincinnati site of the National Institute of Child Health and Human Development Neonatal Research Network were evaluated comparing CPAP (n = 198) vs. MV (n = 109). Primary outcomes included the Bayley Score of Infant Development Version II (BSID-II), presence of deafness, blindness, cerebral palsy, bronchopulmonary dysplasia and death.
Results
Ventilatory groups were similar in gender, rates of preterm prolonged rupture of membranes, antepartum hemorrhage, use of antenatal antibiotics, steroids, and tocolytics. Infants receiving CPAP weighed more, were older, were more likely to be non-Caucasian and from a singleton pregnancy. Infants receiving CPAP had better BSID-II scores, and lower rates of BPD and death.
Conclusions
After adjusting for acuity differences, ventilatory strategy at 24 h of age independently predicts long-term neurodevelopmental outcome in ELBW infants.
Keywords
Extremely low birth weight Neurodevelopmental outcome Mechanical ventilation CPAP BPD DeathNotes
Contributions
All listed authors were involved in the study design, data analysis, and manuscript preparation for this study.
Conflict of Interest
None.
Role of Funding Source
None.
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