Changing trends in the epidemiology and pathogenesis of neonatal chronic lung disease☆,☆☆,★,★★
Section snippets
METHODS
We prospectively examined all consecutively born preterm infants with birth weights between 500 and 1000 gm who were delivered at the University of Miami/Jackson Memorial Medical Center during a 2-year period beginning in March 1989. Only infants who required mechanical ventilation were included in the study. Infants with symptomatic congenital infections or major congenital anomalies were excluded. Detailed perinatal and neonatal information was abstracted on a daily basis by means of specific
RESULTS
A total of 258 preterm infants with birth weights between 500 and 1000 gm were born at the University of Miami/ Jackson Memorial Medical Center during the 2 years of the study. Of these, 93 infants (36%) died during the first 28 days of postnatal life and were excluded from the analysis. Of the 165 survivors, 46 infants met one of the following exclusion criteria: 16 did not require mechanical ventilation; 28 had severe RDS with high oxygen requirements during the first 5 days of life; 1 had a
DISCUSSION
With the introduction of surfactant therapy and new strategies for mechanical ventilation in infants with RDS, it was anticipated that the incidence of CLD would decrease; however, most clinical trials have failed to confirm this expectation.6, 7, 8 On the contrary, investigators have reported an increasing incidence of CLD in preterm infants with mild or no RDS.3, 4, 9 During the 2-year period of our study, CLD developed in 66 (45%) of 147 surviving ventilator-supported infants with birth
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From the Department of Pediatrics, Division of Neonatology, University of Miami School of Medicine, Miami, Florida
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Supported by University of Miami Project: New Born.
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Reprint requests: Eduardo Bancalari, MD, University of Miami School of Medicine, Division of Neonatology, Department of Pediatrics (R-131), PO BOX 016960, Miami, FL 33101.
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0022-3476/95/$3.00 + 0 9/23/61439