Marcovich M, Pollauf F, Rosenkranz A
Padiatr Padol. 1982;17(2):361-70.
The retrospective study of 745 mechanically ventilated newborns showed that 24 (3%) developed radiographic stage IV bronchopulmonary dysplasia. 12 survived, 11 died during their initial hospitalization, 1 died of cardiopulmonary disease at the age of 15 months. All children were prematures, mean age at gestation was 31,5 weeks, mean birth weight was 1520 g. 87% of them showed initial clinical and radiographic features of severe hyaline membrane disease. Artificial positive-pressure ventilation was necessary for at least 30 days. During mechanical ventilation pneumothorax occurred in 25%, interstitial emphysema in 41%. Patent ductus arteriosus was found in 53%. Volume cycled and pressure regulated respirators were used. No significant differences regarding mechanical ventilation (peak pressure, PEEP, FiO2) could be found between those who survived and those who died. Clinical follow-up of those children who survived showed the most of them had slight pulmonary complications during their first year of life. Only two children showed severe cardiopulmonary disease. One of them died at the age of 15 months. The development of bronchopulmonary dysplasia seems to be a result of positive pressure ventilation (high pressure, high oxygen) superimposed upon severe respiratory distress syndrome. The importance of the underlying lung disease seems to be significant.
