[Predictor factors for the production of bronchopulmonary dysplasia in the preterm newborn].

INTRODUCTION

The bronchopulmonary dysplasia (BPD) is a lung illness chronicle that is developed in preterm newborn (PTNB) mainly, secondary to multiple factors of risk which have not been studied completely.

OBJECTIVE

To determine the predictors factors (of risk factors) for the production of BPD in the PTNB of 28 at 36 weeks of gestational age.

MATERIAL AND

METHODS

Eighty medical records from January 2004 to May 2006 of PTNB that there was received mechanical attendance to the ventilation (MAV) at least 24 hrs were reviewed retrospectively. They were divided in two groups: group A, PTNB that had BPD, composed of 40 patients (cases) and group B, PTNB with MAV but that had not developed BPD due to the procedure of 40 patients too (controls). It was used descriptive and inferential statistic. Odds ratio (OR) and multivariate analysis were used to study predictors factors. Statistical significance was considered with P < 0.05.

RESULTS

There was significant difference of the supply of the intravenous (i.v.) fluids the days 2, 3, 4 and 7 of extrauterine life (EUL), of the oxygen inspired fraction (FiO2) of in the day 7 of being had initiate the MAV, of the peak inspiratory pressure (PIP) in the day 1 and 3 of being had initiate the MAV everything to favor of the cases, with P < 0.05. In the multivariate analysis was significative in the intake of i.v. fluids > or = 140 mL x kg of weight x day to the fourth day of EUL, the oxygen arterial pressure (PaO2) > 70 mm Hg for > 4 days, reintubations number (two or more times) and the symptomatic patent ductus arteriosus (PDA), all with P < 0.05.

CONCLUSIONS

We concluded that, in critically sick PTNB, they exist one series of well-known risk factors but more specified in this study that they should avoid as much as possible; the handling of the liquids i.v. should be cautious, not to spend of 139 mL x kg x day to the 4th day of EUL, not to be so permissive with the PaO2 maintaining it in values < or = 70 mm of Hg after four days, to avoid as much as possible the reintubations and to treat the but quick the symptomatic PDA still without that it is significant, to diminish this way, the risk of BPD.