Bubble CPAP as first ventilatory choice in extremely premature infants: Relation to outcomes and bronchopulmonary dysplasia

Abstract

Purpose

Propose an admission strategy of very PTNB, for quality improvement and prevent adverse events, and risk of developing bronchopulmonary dysplasia-BPD, vascular, and neurological outcomes.

Methods

observational prospective cohort study, from 2020 to 2021. All preterms younger than 32 weeks of gestational age were admitted to bCPAP, recorded failure and main outcomes.

Results

26 very PTNB (30 weeks+2 days), 6 presented bCPAP failure and intubated. Outcomes: 1 nasal bleeding, 2 septal hyperemia, 1 septal lesion and 1 pneumomediastinum, 5 peri-intraventricular hemorrhages, negative retinopathy of prematurity in those who underwent the examination, 1 death and 2 had a diagnosis of BPD. A positive association was identified with the need for FIO2 greater than 21% and BPD.

Conclusions

very PTNB can be safely admitted to bCPAP with the implementation of the proposed protocol, provided that the multidisciplinary team is prepared with periodic training. Attention should be given to the proper positioning of the interface and the baby in the bed, in addition to constant monitoring of ventilatory parameters and air temperature. Supplemental oxygen is associated with an increased risk of developing BPD.