A modified physiologic test for bronchopulmonary dysplasia: A clinical tool for weaning from CPAP and/or oxygen-therapy the premature babies?

Giovanni Vento, Valentina Vendettuoli, Claudia Aurilia, Milena Tana, Chiara Tirone, Alessandra Lio, Piero Giuseppe Matassa, Francesca Priolo, Piero Catenazzi, Mirta Corsello, Enrico Zecca, Fabio Mosca

Research output: Contribution to journalArticlepeer-review

Abstract

Background: A physiologic test for estimating BPD rate has been developed by Walsh and collaborators. Actually there are not standard criteria for weaning from CPAP and/or oxygen therapy the premature babies. Aim of this study was to verify if a physiologic test, modified respect to that developed by Walsh and collaborators for estimating BPD rate, can be used as a clinical tool for weaning the premature babies from CPAP and/or oxygen therapy. Methods: Neonates with BW 500-1250 g and GA ≤ 32 weeks, receiving FiO 2 ≤ 0.30 by hood or CPAP, were prospectively studied at 28 days of life and at 36 weeks of postmestrual age. The test was performed in 3 steps: baseline, challenge (FiO 2 and CPAP reduction to room air) and post test (room air). Monitoring of transcutaneous CO 2 was added to SpO 2 and the newborns passing the test were left in room air. Results: Six of 23 tested babies (26%) passed the challenge at 28 days of life, 4 of 10 tested babies (40%) passed the challenge at 36 weeks. Median values of SpO 2 were significantly higher in the neonates passing the test, respect to the failing patients. At the same time median values of TcPCO 2 were significantly higher in the latter babies. Conclusion: TcPCO 2 monitoring appeared to be a new useful parameter for failure prediction of weaning. The test represented a clinical guide because the newborns passing it were left in room air.

Original languageEnglish
Article number2
JournalItalian Journal of Pediatrics
Volume45
Issue number1
DOIs
Publication statusPublished - Jan 4 2019

Keywords

  • Physiologic test
  • Preterm infants
  • Respiratory support weaning

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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