nCPAP as a primary mechanical ventilation method in very low-weight prematures in the Dr. José Eleuterio González University Hospital in Monterrey

Silvia Natalia Téllez Baquero; Elisa Lizbeth Dávila Sotelo; Reyna Rocío Cervantes Rodríguez; Valdemar Abrego Moya

2008, Number 39

<< Back Next >>

Med Univer 2008; 10 (39)

nCPAP as a primary mechanical ventilation method in very low-weight prematures in the Dr. José Eleuterio González University Hospital in Monterrey

Téllez BSN, Dávila SEL, Cervantes RRR, Abrego MV

Full text

How to cite this article

Language: Spanish
References: 19
Page: 87-91
PDF size: 121.53 Kb.

ABSTRACT

Background: Continuous positive airway pressure (CPAP) is a mechanical ventilation method in which supra-atmospheric pressure is applied to the airway of a patient that has spontaneous breathing during the respiratory cycle. CPAP was first used in the 1970s, but its use was more or less abandoned until the 1900s, when it was used again because of studies done in New York and Denmark that proved its advantage in the mechanical ventilation of prematures. We did not find any study of the use of nCPAP in prematures in our country. In the Dr. José Eleuterio Gónzalez University Hospital, a significant number of patients are seen, of which many have limited resources and consequently do not have access to prenatal steroids, reason for which we consider that the use of nCPAP on these patients can be of great benefit. Objective: determine morbidity and mortality related to the use of nCPAP in premature newborns.
Method: Our study is an observational and descriptive study that included newborn babies of 32 weeks of gestation or less, with a birth weight between 1000 and 1500 grams, that where born in the Intensive Care Unit of the Dr. José Eleuterio Gónzalez University Hospital and to whom nCPAP was applied as the primary method of mechanical ventilation.
Results: The thirty one patients who were included had the following diseases: bronchopulmonary dysplasia 12.9%; hyaline membrane disease (respiratory distress syndrome) 83.8%, sepsis 33.4%, failure of nCPAP 29% and a mortality of 12.9%.
Conclusions: CPAP is a safe mechanical ventilation method, cost effective and viable in the population we studied.

REFERENCES

Stefanescu BM, Murphy W, Hansell B, Fuloria M, Morgan T, Aschner L. A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants. Pediatrics 2003;5:1031-8.
Jobe A, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9.
Young T, Kruyer L, Marshall D, Bose C. Population-based study of chronic lung disease in very low birth weight infants in North Carolina in 1994 with comparisons with 1984. Pediatrics 1999;104:e17.
Narendran V, Donovan EF, Hoath SB, Akinbi HT, Steichen J, Jobe AH. Early bubble CPAP and outcomes in ELBW preterm infants. J Perinatol 2003;23:195-9.
National Institutes of Health. Report of the consensus development conference on the effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Publication 1994;95:3784.
Northway W, Rosan R, Porter D. Pulmonary disease following respiratory therapy of hyaline membrane disease: bronchopulmonary dysplasia. N Engl J Med 1967;276:357-68.
Avery M, Tooley W, Keller J, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers.Pediatrics 1987;79:26-30.
Van Marter L, Allred E, Pagano M, et al. Do clinical markers of barotrauma and oxygen toxicity explain interhospital variation in rates of chronic lung disease? Pediatrics 2000;105:1194-201.
Subrananiam P, Henderson-Smart DJ, Davis PG. Prophylactic nasal continuous positive airways pressure for preventing morbidity and mortality in very preterm infants. The Cochrane Database of Systematic Reviews 1998;4:CD001243.
Kamper J, Wulff K, Larsen C, Lindequist S. Early treatment with nasal continuous positive airway pressure in very low birthweight infants. Acta Paediatr 1993;82:193-7.
Jacobson T, Gronvall J, Petersen S, Andersen GE. “Minitouch” treatment of very low birthweight infants. Acta Paediatr 1993;82:934-8.
Lundstrom KE, Greisen G. Early treatment with early CPAP. Acta Pediatr 1993;82:856.
de Klerk AM, de Klerk RK. Use of continuous positive airway pressure in preterm infants: Comments and experience from New Zealand. Pediatrics 2001;3:761.
Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 1972;50:515-25.
Taeusch HW, Ballard RA. Tratado de neonatología de Avery. 8a ed. Madrid: Elsevier, 2007.
Tucker J, McGuire W. ABC of preterm birth. Epidemiology if preterm birth. BMJ 2004;675:329.
Alfonso I, Papazian O, Altman D. Neuroneonatology. http://pediatricneuro. com/alfonso/main.htm
Mazzella M, Bellini C, Calevo MG, Campone F. A randomized control study comparing the Infant Flow Driver with nasal continuous positive airway pressure in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001;85:F86-F90.
Finer NN, Carlo WA, Duara S, Fanaroff AA, et al. Delivery room continuous positive airway pressure/positive end-expiratory pressure in extremely low birth weight infants: a feasibility trial. Pediatrics 2004;3:651-7.