Factors associated with the use of oxygen therapy and ventilatory support in premature newborns
DOI:
https://doi.org/10.17267/2238-2704rpf.2022.e4471Keywords:
Premature, Neonatal Intensive Care Unit, Ventilatory Support, Oxygen therapyAbstract
INTRODUCTION: Therapy with supplemental oxygen reduces hypoxia, reducing mortality among premature newborns (PTNB), however, excessive exposure to oxygen has the potential to reach and damage multiple organs of the neonate. OBJECTIVE: To determine the factors associated with the use of ventilatory support/oxygen therapy in PTNBs. MATERIALS AND METHODS: Observational, longitudinal, prospective study of a quantitative nature, carried out from July 2019 to March 2020, in a neonatal intensive care unit (NICU) of a public university hospital. PTNBs using oxygen therapy were observed from the period of admission to discharge, with gestational and birth data and oxygen therapy parameters being collected. RESULTS: 62 PTNBs were followed up with a mean gestational age (GA) of 30.5 weeks (±3.43) and a median birth weight (BW) of 1,390 grams (555 g - 3,115 g). The mean length of hospital stay of 35 days (3-176) and of oxygen therapy was 7.5 days (1-176). When relating the total number of days on oxygen therapy with the Apgar value at the 5th minute, there was no significant relationship (rho= -0.158; p=0.219), however, there was a relationship with GA at birth (rho= -0.725; p<0.001 ), use of antennal steroids (p=0.006) and exogenous surfactant (<0.001). There was also a relationship with bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (p<0.001). CONCLUSION: The factors associated with time and use of oxygen therapy were GA, PN, use of antennal steroids and exogenous surfactant, and an association with BPD and ROP was also observed.
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(1) Soares LG, Sauka JM, Higarashi IH, Soares LG, Filipin LCS, Uema RTB. Effects of oxygenotherapy in neonatology: integrating literature review. Rev enferm atual in derme. 2019;87(25). https://doi.org/10.31011/reaid-2019-v.87-n.especial-art.165
(2) Kayton A, Timoney P, Vargo L, Perez JA. A Review of Oxygen Physiology and Appropriate Management of Oxygen Levels in Premature Neonates. Adv Neonatal Care. 2018; 18(2):98-104. https://doi.org/10.1097/ANC.0000000000000434
(3) Walsh BK, Smallwood CD. Pediatric Oxygen Therapy: A Review and Update Brian. Resp Care. 2017;62(6):645-661. https://doi.org/10.4187/respcare.05245
(4) Deuber C, Terhaar M. Hyperoxia in very preterm infants: A systematic review of the literature. J. Perinat Neonat Nurs. 2011;25(3):268-274. https://doi.org/10.1097/jpn.0b013e318226ee2c
(5) Cherian S, Morris I, Evans J, Kotecha S. Oxygen therapy in preterm infants. Paediatr Respir Rev. 2014; 15(2):135-41. https://doi.org/10.1016/j.prrv.2012.12.003
(6) Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Delineando a pesquisa clínica. 4a ed. Porto Alegre: Editora Artmed; 2015.
(7) Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 3 a ed. Philadelphia: F.A. Davis Compan; 2015.
(8) Jobe AH, Goldenberg RL. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks. Am. J. Obstet. Gyneco. 2018;219(1):62-74. https://doi.org/10.1016/j.ajog.2018.04.007
(9) Thomsom L, Paton J. Oxygen Toxicity. Paediatr. Respir. Rev. 2014;15(2): 120-3. https://doi.org/10.1016/j.prrv.2014.03.003
(10) Shi Y, Muniraman H, Biniwale M, Ramanathan R. A Review on Non-invasive Respiratory Support for Management of Respiratory Distress in Extremely Preterm Infants. Front Pediatr. 2020;8:270. https://doi.org/10.3389/fped.2020.00270
(11) Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, te Pas A, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome. Neonat. 2019;115(4):432-450. https://doi.org/10.1159/000499361
(12) Sarmento GJV. Fisioterapia respiratória em pediatria e neonatologia. 2ª ed. São Paulo: Manole; 2011.
(13) Shalish W, Kanbar L, Kovacs L, Chawla S, Keszler M, Rao S, et al. The Impact of Time Interval between Extubation and Reintubation on Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants. J Pediatr. 2019;205(2):70-76. https://doi.org/10.1016/j.jpeds.2018.09.062
(14) Guedes JM, Conceição SL, Albergaria TFS. Deleterial effects of invasive mechanical ventilation in prematures: systematic review. Rev Pesq Fisio. 2018;8(1):119-130. https://doi.org/10.17267/2238-2704rpf.v8i1.1772
(15) Ancora G, Lago P, Garetti E, Pirelli A, Merazzi D, Pierantoni L, et al. Follow-up ar the corrected age off 24 months of preterm newborns reveiving continuous infusion of fentanyl for pain control during mechanical ventilation. J. Pain. 2017;158(5):840-45. https://doi.org/10.1097/j.pain.0000000000000839
(16) McPherson C, Wambach JA. Prevention and Treatment of Respiratory Distress Syndrome in Preterm Neonates. Neonat Net. 2018;37(3):169-177. https://doi.org/10.1891/0730-0832.37.3.169
(17) Blankenship SA, Brown KE, Simon LE, Stout MJ, Tuuli MG. Antenatal Corticosteroids in Preterm Small-for-Gestational Age Infants: A Systematic Review and Meta-Analysis. Am J Obstet Gynecol MFM. 2020;2(4):100215. https://doi.org/10.1016/j.ajogmf.2020.100215
(18) Torres-Cuevas I, Parra-Llorca A, Sánchez-Illana A, Nuñez-Ramiro A, Kuligowski J, Cháfer-Pericás C, et al. Oxygen and oxidative stress in the perinatal period. Red Biol. 2017;12:674-681. https://doi.org/10.1016/j.redox.2017.03.011
(19) Lima MRO, Andrade MA, Araújo APG, Figueroa JN, Andrade LB. Influence of maternal and neonatal factors on bronchopulmonary dysplasia development. Rev. Assoc. Med. Bras. 2011;57(4):398-403. https://doi.org/10.1590/S0104-42302011000400012
(20) Silva GAA, Annes ALM, Pisco MDBV, Silva RM. Displasia Broncopulmonar: definição, fisiopatologia e tratamento: revisão da literatura. Inov Saúd. 2017;6(1):93-106. https://doi.org/10.18616/is.v6i1.2746
(21) Higgins RD. Oxygen Saturation and Retinopathy of Prematurity. Clin Perinatol. 2019;46(3):593-9. https://doi.org/10.1016/j.clp.2019.05.008
(22) Xavier MSLR, Santos TMSA. Ocorrência de retinopatia da prematuridade em recém-nascidos de muito baixo peso em maternidade de referência terciária no município de Fortaleza – CE. Rev Med UFC. 2019;59(4):7-13. https://doi.org/10.20513/2447-6595.2019v59n4p7-13
(23) Tapia JL, Agost D, Alegria A, Standen J, Escobar M, Grandi C, et al. Bronchopulmonary dysplasia: incidence, risk factors and resource utilization in a population of South-American very low birth weight infants. J Pediatr. 2006;82(1):15-20. https://doi.org/10.1590/S0021-75572006000100005
(24) Tarnow-Mordi W, Kirby A. Current Recommendations and Practice of Oxygen Therapy in Preterm Infants. Clin Perinatol. 2019;46(3):621-636. https://doi.org/10.1016/j.clp.2019.05.015
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Copyright (c) 2022 Camila de Souza Espíndola, Marimar Goretti Andreazza, Fernanda Cremasco Zechim, Rafael Jurkevicz , Sibele Y. Mattozo Takeda , Ana Lúcia Figueiredo Sarquis
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
