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Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates

The development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use...

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Autores principales: Ramos-Navarro, Cristina, González-Pacheco, Noelia, Rodríguez-Sánchez de la Blanca, Ana, Sánchez-Luna, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266384/
https://www.ncbi.nlm.nih.gov/pubmed/32488737
http://dx.doi.org/10.1007/s00431-020-03694-5
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author Ramos-Navarro, Cristina
González-Pacheco, Noelia
Rodríguez-Sánchez de la Blanca, Ana
Sánchez-Luna, Manuel
author_facet Ramos-Navarro, Cristina
González-Pacheco, Noelia
Rodríguez-Sánchez de la Blanca, Ana
Sánchez-Luna, Manuel
author_sort Ramos-Navarro, Cristina
collection PubMed
description The development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use of higher frequencies (above 15 Hz) and lower high-frequency tidal volumes (VThf). The purpose of this observational study was to assess how survival without bronchopulmonary dysplasia grades 2 and 3 (SF-BPD) is influenced by these modifications in the respiratory strategy applied to preterm infants (gestational age < 32 weeks at birth) who required mechanical ventilation (MV) in the first 3 days of life. We compared a baseline period (2012–2013) against a period in which this strategy had been fully implemented (2016–2017). A total of 182 patients were exposed to MV in the first 3 days of life being a higher proportion on HFOV at day 3 in the second period 79.5% (n 35) in 2016–2017 vs 55.4% (n 31) in 2012–2013. After adjusting for perinatal risk factors, the second period is associated with an increased rate of SF-BPD (OR 2.28; CI 95% 1.072–4.878); this effect is more evident in neonates born at a gestational age of less than 29 weeks (OR 4.87; 95% CI 1.9–12.48). Conclusions : The early use of HFOV combined with the use of higher frequencies and very low VT was associated with an increase in the study population’s SF-BPD.
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spelling pubmed-72663842020-06-03 Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates Ramos-Navarro, Cristina González-Pacheco, Noelia Rodríguez-Sánchez de la Blanca, Ana Sánchez-Luna, Manuel Eur J Pediatr Original Article The development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use of higher frequencies (above 15 Hz) and lower high-frequency tidal volumes (VThf). The purpose of this observational study was to assess how survival without bronchopulmonary dysplasia grades 2 and 3 (SF-BPD) is influenced by these modifications in the respiratory strategy applied to preterm infants (gestational age < 32 weeks at birth) who required mechanical ventilation (MV) in the first 3 days of life. We compared a baseline period (2012–2013) against a period in which this strategy had been fully implemented (2016–2017). A total of 182 patients were exposed to MV in the first 3 days of life being a higher proportion on HFOV at day 3 in the second period 79.5% (n 35) in 2016–2017 vs 55.4% (n 31) in 2012–2013. After adjusting for perinatal risk factors, the second period is associated with an increased rate of SF-BPD (OR 2.28; CI 95% 1.072–4.878); this effect is more evident in neonates born at a gestational age of less than 29 weeks (OR 4.87; 95% CI 1.9–12.48). Conclusions : The early use of HFOV combined with the use of higher frequencies and very low VT was associated with an increase in the study population’s SF-BPD. Springer Berlin Heidelberg 2020-06-02 2020 /pmc/articles/PMC7266384/ /pubmed/32488737 http://dx.doi.org/10.1007/s00431-020-03694-5 Text en © Springer-Verlag GmbH Germany, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Ramos-Navarro, Cristina
González-Pacheco, Noelia
Rodríguez-Sánchez de la Blanca, Ana
Sánchez-Luna, Manuel
Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title_full Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title_fullStr Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title_full_unstemmed Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title_short Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
title_sort effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266384/
https://www.ncbi.nlm.nih.gov/pubmed/32488737
http://dx.doi.org/10.1007/s00431-020-03694-5
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