Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Science and Medicine, King's College London, London, UK.
Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.
Acta Paediatr. 2021 Jul;110(7):2052-2058. doi: 10.1111/apa.15801. Epub 2021 Feb 15.
To determine whether the duration of invasive ventilation predicted the development of bronchopulmonary dysplasia (BPD) and need for discharge home on supplementary oxygen in extremely preterm infants.
Retrospective whole-population study of all infants <28 weeks of gestation admitted to a neonatal unit in England between 2014 and 2018. BPD development was defined as any respiratory support at 36 weeks postmenstrual age. The performance of the duration of mechanical ventilation to predict BPD or discharge home on oxygen was assessed by receiver operator characteristic curve analysis.
The 11,806 infants had a median (IQR) gestational age of 26.0(24.9-27.1) weeks and birthweight of 0.81(0.67-0.96) kg. At discharge from neonatal care, 9,415 infants (79.7%) were alive. The incidence of BPD was 57.5% and of home oxygen 29.4%. Mechanical ventilation duration had areas under the curve of 0.793 and 0.703 in predicting BPD and home oxygen, respectively. Mechanical ventilation for >8 days predicted BPD development with 71% sensitivity and 71% specificity and mechanical ventilation for >10 days predicted discharge on home oxygen with 66% sensitivity and 65% specificity.
In extremely preterm infants, the duration of invasive support predicted BPD and need for home oxygen with moderate sensitivity and specificity.
确定有创通气时间是否可预测极早产儿支气管肺发育不良（BPD）的发生和需要补充氧出院回家。
对 2014 年至 2018 年期间在英国一家新生儿病房住院的所有<28 周龄的婴儿进行回顾性全人群研究。BPD 定义为任何在 36 周校正胎龄时的呼吸支持。通过接受者操作特征曲线分析评估机械通气持续时间预测 BPD 或出院时需吸氧的性能。
11806 例婴儿的中位（IQR）胎龄为 26.0（24.9-27.1）周，出生体重为 0.81（0.67-0.96）kg。出院时，9415 例（79.7%）婴儿存活。BPD 的发生率为 57.5%，家庭吸氧的发生率为 29.4%。机械通气持续时间预测 BPD 和家庭吸氧的曲线下面积分别为 0.793 和 0.703。机械通气时间>8 天预测 BPD 发展的敏感性和特异性分别为 71%和 71%，机械通气时间>10 天预测出院时需家庭吸氧的敏感性和特异性分别为 66%和 65%。
在极早产儿中，有创支持的持续时间对 BPD 和需要家庭吸氧具有中等敏感性和特异性。
