SHORT-TERM PREDICTIVE FACTORS FOR THE OUTCOME OF PRETERM INFANTS DEPENDING ON THE METHOD OF RESPIRATORY SUPPORT
Respiratory support issues regarding preterm newborns show increasingly theoretical and clinical interest. Aim: To monitor the outcome of preterm infants with respiratory distress receiving different methods of respiratory support. Materials and methods: We performed a 5-year observational study (2013-2016) of 750 preterm infants with respiratory distress. The cases included in the study were divided into three groups as follows: group 1 - 476 premature newborns from IMSP IMsC (The Institute for Mother and Child Health) Chisinau (level III maternity hospital); group 2 - 240 premature infants transferred by the AVIASAN aerial service from level I and II to level III maternity hospitals, and group 3 - 34 premature babies from IMSP IMsC Chisinau which received surfactant administered by the LISA (Less Invasive Surfactant Administration) method. Data were analyzed using SPSS 21.0 software (IBM Statistical Package for the Social Sciences, Chicago, Illinois). Results: 42.67% of the cases did not require initial respiratory support and in 36.8% of cases, CPAP (Continuous Positive Airway Pressure) was used. Of the cases which were at first on CPAP, 6.27% were transferred on conventional mechanical ventilation (CMV) and 4.8% on high frequency ventilation (HFV). Of the newborns who initially received CMV, 5.33% were later transferred on CPAP and 4.13% required HFV. Our results showed that mechanical ventilation had been applied particularly in low gestational age newborns - the mean gestational age was significantly lower in these infants (p < 0.01). Both in newborns from level III perinatal center and those from level I and II maternity hospitals, gestational age was significantly lower in those who required CMV or HFV. Conclusions: Due to the implementation of contemporary methods of respiratory support for preterm infants their survival rate has greatly improved. However, the possibility for oxygen therapy remains limited in low-resource settings. Thus, in the Republic of Moldova, high quality respiratory support remains a valid option only for the level III perinatal center - IMSP IMsC.
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