Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso

Abstract

Objective: To determine the incidence of bronchopulmonary dysplasia, its risk factors and resource utilization in a large South American population of very low birth weight infants.Methods: Prospectively collected data in infants weighing 500 to 1,500 g born in 16 NEOCOSUR Network centers from 10/2000 through 12/2003. Multivariate relative risk and 95% confidence intervals were estimated by Poisson regression with robust error variance to find factors that affected the risk of bronchopulmonary dysplasia.Results: 1,825 very low birth weight infants survivors were analyzed. Mean birth weight and gestational age were1085±279 g and 29±3 weeks respectively. Bronchopulmonary dysplasia incidence averaged 24.4% and survival without bronchopulmonary dysplasia augmented with increasing gestational age. A higher birth weight and gestational age and a female gender all decreased the risk for bronchopulmonary dysplasia. Factors that independently increased that risk were surfactant requirement, mechanical ventilation, airleak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. Bronchopulmonary dysplasia infants had more days of hospitalization (91±27 vs. 51±19), of mechanical ventilation (19±20 vs. 4±7) and oxygen therapy (72±30 vs. 8±14) in comparison with non BPD infants.Conclusions: Bronchopulmonary dysplasia incidence was 24.4% in a large South American population and is related to greater resource utilization. Population and is related to greater resource utilization. Risk factors for bronchopulmonary dysplasia in this study were: surfactant requirement, mechanical ventilation, airleak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. These studies may provide useful information in the design of effective preventive perinatal strategies.J Pediatr (Rio J). 2006;82(1):15-20: Bronchopulmonary dysplasia, very low birth weight, risk factors, resource utilization, neonates.

Clinical profile of newborns undergoing physical therapy in a neonatal intensive care unit

“…Among the complications associated with low birth weight and extremely low birth weight there are neonatal infections, respiratory distress syndrome, retinopathy of prematurity, perinatal anoxia, periintraventricular hemorrhage, periventricular leukomalacia, metabolic disorders, necrotizing enterocolitisand patent ductus arteriosus,with the development of bronchopulmonary dysplasia in the long term, this being one of the most important chronic complications in preterm survivors (25).…”

Displasia Broncopulmonar: Definição, Fisiopatologia e Tratamento: Revisão da Literatura

“…95 ISSN 2317-2460 -doi: http://dx.doi.org/10.18616/is.v4i2.2238. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] articles were used from 2000 to 2016. Discussion: Bronchopulmonary dysplasia is a multifactorial disease.…”

“…A displasia broncopulmonar é uma doença multifatorial, que vai desde a intoxicação por frações inspiradas de oxigênio elevadas e uso de ventilação mecânica invasiva por longos períodos de tempo a doenças pré-existentes, como persistência do canal arterial, síndrome das membranas hialinas (síndrome do desconforto respiratório do recém-nascido), infecções neonatais e outras doenças 1,2,3,4,5,6,7,8 .…”

“…Apresentam taquidispnéia com tosse. Com ausculta pulmonar rica em sibilos e com murmúrio vesicular diminuído, a hipoxemia está presente e muitas vezes acompanhada de hipercapnia [1][2][3][4] .…”

“…A displasia broncopulmonar é uma pneumopatia que foi descrita pela primeira vez por Northway et al em 1967, sendo referida como uma doença pulmonar crônica do recém-nascido com morbidades da prematuridade, principalmente a Síndrome do Desconforto Respiratório (SDR), e tinha como apresentação clínica característica e bem definida tiragens intercostais, batimento de asa de nariz, uso de musculatura acessória e assincronia toraco-abdominal e necessidade constante de utilização de oxigênio de baixo ou alto fluxo nos casos mais graves [1][2][3] .…”