Bronchopulmonary dysplasia. Survival after prolonged mechanical ventilation
R. L. Gibson, J. C. Jackson, G. A. Twiggs, G. J. Redding and W. E. Truog
Department of Pediatrics, University of Washington School of Medicine, Seattle.
We reviewed the records of 4778 infants who were admitted to the affiliated
intensive care nurseries at the University of Washington in Seattle from
Jan 1, 1980, through Dec 31, 1983. We evaluated the outcome for patients
with bronchopulmonary dysplasia who required mechanical ventilation and
supplemental oxygen for at least six months. Eight (53%) of 15 study
patients were alive at 3 years of age. Preselected indexes measured during
the first six months of life that were not associated with death before 3
years of age included growth measurements, fraction of inspired oxygen at 6
months of age, mean airway pressure, arterial partial pressure of carbon
dioxide, and right ventricular hypertrophy. In contrast, recurrent cyanotic
episodes requiring intermittent muscle paralysis or long-term sedation
therapy to maintain gas exchange occurred in six of seven nonsurvivors and
only one of eight survivors. The survivors have reactive airway disease and
recurrent lower respiratory tract infections.
