International journal of pediatrics · 2026
Mechanical Ventilation and Survival Without Major Morbidity in Very-Low-Birth-Weight Infants: A Multicenter Study.
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Toso Alberto, Kuzmanic Daniela, Dominguez Angelica, Gonzalez Alvaro, Herbozo Cecilia, Brener Dik Pablo H, Ahumada Luis A, Mendez Alvaro, Aburto Claudia, Tapia Jose L, NEOCOSUR Neonatal Network
Аннотация
BACKGROUND: Mechanical ventilation (MV) is a frequent lifesaving therapy in very low birthweight (VLBW) infants, although it poses risks and may present complications.
OBJECTIVE: To evaluate the association between the use and duration of MV and survival without major morbidity (SWMM) in VLBW infants according to gestational age (GA).
METHODS: Multicenter retrospective study of prospectively collected data of premature infants weighing 500-1500 g and 24-30 weeks of GA, born between 2010 and 2019 at NEOCOSUR Neonatal Network centers. Baseline characteristics and neonatal outcomes were compared between ventilated and nonventilated VLBW infants. Stratification for each week of GA was performed. Adjusted odds ratios and 95% confidence intervals (CIs) were calculated for main outcomes by logistic regression, adjusted for birthweight, GA, sex, mode of delivery, respiratory distress syndrome (RDS), antenatal corticosteroids, small for gestational age (SGA), and Apgar scores. Infants with congenital anomalies and those who died before discharge were excluded.
RESULTS: A total of 7040 infants were included in the analysis. Among these, 4993 (70.9%) were ventilated and 2047 (29.1%) were not. Nonventilated infants were larger, healthier at birth, and presented fewer major adverse outcomes (p < 0.001). SWMM in ventilated patients was 35.9%, compared with 73.4% in nonventilated infants (OR = 0.35; 95% CI: [0.31-0.40]). SWMM of ventilated infants remained lower at all GA intervals after risk adjustment. MV duration was also associated with a decrease in SWMM; each additional day of MV was associated with 7.9% lower odds of SWMM (OR = 0.921; 95% CI: [0.913-0.930]).
CONCLUSIONS: The use and duration of MV were associated with a significant decrease in SWMM in this population of VLBW infants, despite risk adjustment.
OBJECTIVE: To evaluate the association between the use and duration of MV and survival without major morbidity (SWMM) in VLBW infants according to gestational age (GA).
METHODS: Multicenter retrospective study of prospectively collected data of premature infants weighing 500-1500 g and 24-30 weeks of GA, born between 2010 and 2019 at NEOCOSUR Neonatal Network centers. Baseline characteristics and neonatal outcomes were compared between ventilated and nonventilated VLBW infants. Stratification for each week of GA was performed. Adjusted odds ratios and 95% confidence intervals (CIs) were calculated for main outcomes by logistic regression, adjusted for birthweight, GA, sex, mode of delivery, respiratory distress syndrome (RDS), antenatal corticosteroids, small for gestational age (SGA), and Apgar scores. Infants with congenital anomalies and those who died before discharge were excluded.
RESULTS: A total of 7040 infants were included in the analysis. Among these, 4993 (70.9%) were ventilated and 2047 (29.1%) were not. Nonventilated infants were larger, healthier at birth, and presented fewer major adverse outcomes (p < 0.001). SWMM in ventilated patients was 35.9%, compared with 73.4% in nonventilated infants (OR = 0.35; 95% CI: [0.31-0.40]). SWMM of ventilated infants remained lower at all GA intervals after risk adjustment. MV duration was also associated with a decrease in SWMM; each additional day of MV was associated with 7.9% lower odds of SWMM (OR = 0.921; 95% CI: [0.913-0.930]).
CONCLUSIONS: The use and duration of MV were associated with a significant decrease in SWMM in this population of VLBW infants, despite risk adjustment.