Improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates who have received antenatal steroids and surfactant
E A Gaillard, R W I Cooke, N J Shaw
Liverpool Women's
Hospital, Liverpool L8 7SS, UK
Correspondence to: Dr Shaw, Regional Intensive Care Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK Ben.Shaw{at}lwh-tr.nwest.nhs.uk
Accepted 9 January
2001
AIMS
To assess
survival and neurodevelopmental outcome following prolonged
ventilation beyond 27 or 49 days of postnatal life in neonates treated
with antenatal steroids and surfactant.
METHODSThe medical
records of 84 babies born in 1994-1996 requiring ventilation after
27 postnatal days at Liverpool Women's Hospital were reviewed to
determine the duration of mechanical ventilation, survival, and
neurodevelopmental outcome at 3 years of age.
RESULTSFifty six
babies were mechanically ventilated after 27 postnatal days but for
less than 50 days; 48 (86%) survived to 3 years. Twenty six (54%) of
the survivors had normal neurodevelopment at 3 years and seven (15%)
had only mild disability. Twenty eight babies were ventilated after 49 postnatal days; 14 survived to 3 years. Five of these survivors were
neurodevelopmentally normal at 3 years and two had mild disability.
CONCLUSIONSSurvival
decreases with more prolonged ventilation. When antenatal steroids and
postnatal surfactant are used, there appears to be improved survival
and neurodevelopmental outcome in preterm babies who require prolonged ventilation.
Keywords: prolonged ventilation; preterm; neurodevelopmental outcome; survival
© 2001 by Archives of Disease in Childhood
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