1161 Early Respiratory Management and Bronchopulmonary Dysplasia Development in Very Preterm Newborns

Bronchopulmonary dysplasia (BPD) remains important mostly unpreventable cause of morbidity of very preterm infants significantly affecting their long-term outcomes. In a cohort study we evaluated the possible protective effect of early noninvasive respiratory support on BPD development. Methods: 100 very low birth weight newborns with gestational age of 28,37±2,0 wk who survived to corrected age of 36 wk were under observation. BPD, defined as oxygen dependency at 36 wk adjusted gestational age, has developed in 25 of them (BPD group). 75 infants without BPD were included into the control group. Perinatal data, delivery room interventions, nasal CPAP as well as mechanical ventilation use and duration were compared in the groups. Results: Infants from the BPD group were intubated in delivery room and needed initial mechanical ventilation more often than newborns from the control group (15 [60%] vs. 27 [36%], p< 0,05 and 22 [88%] vs. 40 [53%], p< 0,05; accordingly). Duration of the initial period of mechanical ventilation was also significantly higher in infants from the BPD group (118 [69-162] hrs vs. 48 [24-86] hrs; p< 0,001). At the same time, newborns initially treated with CPAP less likely developed BPD (35 [47%] in the control group as compared to 3 [12%] in the BPD group; p< 0,01). This protective effect remained significant after controlling for gestational age, low 5 min Apgar score and severity of RDS (adjusted OR 0,46; 95% CI 0,23-0,78). Conclusions: Our data support the current concept of protective role of early noninvasive respiratory support for BPD development.