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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2009, Number 6

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Rev Invest Clin 2009; 61 (6)

Predictors factors for the production of bronchopulmonary dysplasia in the preterm newborn

Tapia-Rombo CA, Córdova-Muñiz NE, Ballesteros-Del-Olmo JC, Aguilar-Solano AMG, Sánchez-García L, Gutiérrez-González GA, Cuevas-Urióstegui ML

Language: Spanish
References: 41
Page: 466-475
PDF size: 87.76 Kb.


ABSTRACT

Introduction. The bronchopulmonary dysplasia (BPD) is a lung illness chronicle that is developed in preterm newborn (PTNB) mainly, secondary to multiple factors of risk which have not been studied completely. Objective. To determine the predictors factors (of risk factors) for the production of BPD in the PTNB of 28 at 36 weeks of gestational age. Material and methods. Eighty medical records from January 2004 to May 2006 of PTNB that there was received mechanical attendance to the ventilation (MAV) at least 24 hrs were reviewed retrospectively. They were divided in two groups: group A, PTNB that had BPD, composed of 40 patients (cases) and group B, PTNB with MAV but that had not developed BPD due to the procedure of 40 patients too (controls). It was used descriptive and inferential statistic. Odds ratio (OR) and multivariate analysis were used to study predictors factors. Statistical significance was considered with P ‹ 0.05. Results. There was significant difference of the supply of the intravenous (IV) fluids the days 2, 3, 4 and 7 of extrauterine life (EUL), of the oxygen inspired fraction (FiO2) of in the day 7 of being had initiate the MAV, of the peak inspiratory pressure (PIP) in the day 1 and 3 of being had initiate the MAV everything to favor of the cases, with P ‹ 0.05. In the multivariate analysis was significative in the intake of IV fluids ≥ 140 mL x kg of weight x day to the fourth day of EUL, the oxygen arterial pressure (PaO2) › 70 mm Hg for › 4 days, reintubations number (two or more times) and the symptomatic patent ductus arteriosus (PDA), all with P ‹ 0.05. Conclusions. We concluded that, in critically sick PTNB, they exist one series of well-known risk factors but more specified in this study that they should avoid as much as possible; the handling of the liquids IV should be cautious, not to spend of 139 mL x kg x day to the 4th day of EUL, not to be so permissive with the PaO2 maintaining it in values ≤ 70 mm of Hg after four days, to avoid as much as possible the reintubations and to treat the but quick the symptomatic PDA still without that it is significant, to diminish this way, the risk of BPD.


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