Current respiratory support practices in premature infants: an observational study

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Critical Care

Background:

• Premature infants often require respiratory support due to immature lungs.
• Understanding current ventilation practices is crucial for optimizing care in neonatal intensive care units (NICUs).

Purpose of the Study:

• To longitudinally describe invasive and non-invasive ventilation practices in premature infants.
• To analyze trends in respiratory support based on gestational age and time period.

Main Methods:

• Retrospective chart review of 682 premature infants (gestational age ≤35 weeks) admitted to Erasme Hospital NICU from 2001-2011.
• Infants stratified into three groups based on gestational age: <28 weeks (group 1), 28-31 weeks (group 2), and 32-35 weeks (group 3).
• Analysis of ventilatory support modes, duration, and age at support cessation.

Main Results:

• Group 1 (<28 weeks): 22% received non-invasive ventilation; median endotracheal ventilation 6 days, non-invasive support 41 days.
• Group 2 (28-31 weeks): 10.2% needed no support, 42% received non-invasive support; median endotracheal ventilation 1 day, non-invasive support 17 days.
• Group 3 (32-35 weeks): 34.9% needed support (65% non-invasive); median endotracheal ventilation 2 days, non-invasive support 2 days. Invasive ventilation decreased in group 2.
• Median age at respiratory support cessation was 33-34 weeks corrected age for infants requiring support.

Conclusions:

• Significant diversity and complementarity exist between respiratory support modes for premature infants.
• Non-invasive ventilation is increasingly utilized, particularly in later preterm groups.
• Invasive ventilation duration remains prolonged for the most premature infants (group 1).