Trends in respiratory management and morbidities of very preterm or very low birth weight infants from 2000 to 2013: results from a Portuguese tertiary level Neonatal Intensive Care Unit

Summary: Considerable progress has been made regarding children’s morbidity and mortality. Nonetheless, recent developments have been insufficient to meet set targets. This study aims to evaluate trends and outcomes in respiratory management following a 14-year collaboration with the Vermont Oxford Network (VON). Methods: Data were collected prospectively at a Level III NICU in the North of Portugal and submitted to the VON between 2000 and 2013. The primary outcome was bronchopulmonary dysplasia (BPD). Pneumothorax and respiratory distress syndrome were secondary outcomes. Results: A total of 323 very low birth weight infants hospitalised in our centre met the inclusion criteria. Significant changes were observed with supplemental oxygen use and endotracheal intubation decreasing, whilst surfactant use rose. Conventional ventilation techniques at any time were used less often. No differences in the rates of BPD were observed. Conclusion: A review of current practice has led to a more cautious approach, privileging less invasive ventilatory techniques and pondered oxygen supplementation, albeit with no significant improvement in the evaluated respiratory outcomes.This study was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), under the Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref.UID/DTP/04750/2013) and the Ph.D. Grant SFRH/BD/111794/2015, co-funded by the FCT and the POCH/FSE Program