Continuous Positive Airway Pressure by Nasal Cannula in Infants with Birthweight Equal or Less Than 1250g. an Alternative of Ventilatory Support

The elevated mortality and high proportion of sequelae associated with the use of intermittent positive pressure ventilation (IPPV) in very low birthweight infants (VLBW) has lead to new modalities of ventilatory support. Non controlled studies have shown a reduction in mortality, incidence of bronchopulmonary dysplasia (BPD) and intracraneal hemorrhage, with the use of nasal continuous positive airway pressure (nCPAP) in this group. The purpose of this retrospective study was to compare the use of nCPAP (n=15) v/s IPPV (n=25), in 40 infants of ≤ 1250g at birth, with an average birthweight of 908 ± 309g and gestational age of 28,1 ± 0,28 weeks. Both groups were comparable in weight, gestational age, perinatal history, mode of delivery and APGAR test. The need for ventilatory support in both strategies was similar /except for apnea and inefficient ventilation of the preterm infant which were more frequent in the nCPAP group), nevertheless the frequency of intracreaneal hemorrhage, pulmonary hemorrhage, and BPD were higher in the IPPV hroup. Infants in nCPAP showed no mortality, presented accelerated nutritional recovery and 20% of them had severe BPD. The IPPV group showed 80% mortality (respiratory distress syndrome, infectious complications and intracraneal hemorrhage) and a 100% of the survivors presented severe BPD (p≤0,01, using Chi square, t-test, Wilcoxon Rank Test).