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  • Title: [Treatment results in 951 newborn infants with IRDS (idiopathic respiratory distress syndrome), especially in relation to artificial respiration from 1967 through 1981].
    Author: de Kleine MJ, Peters GJ, Deen L, Koppe JG.
    Journal: Tijdschr Kindergeneeskd; 1984 Jun; 52(3):71-81. PubMed ID: 6390781.
    Abstract:
    UNLABELLED: Evaluation of intermittent positive pressure ventilation (IPPV) in newborn children is presented by analysis of the data of all 951 children with hyaline membrane disease (HMD) treated in the Wilhelmina Gasthuis during the years 1967-1981. Gestational age varied from 24 to 39 weeks. Birthweight varied from 600-4660 grams. RESULTS: Overall survival was 64.9%. The incidence of pneumothorax, intracranial hemorrhage and bronchopulmonary dysplasia (BPD) was 11.5%, 18.2% and 11.3% respectively, related to the total number of patients. The overall survival did not change. The mean gestational age decreased from 31.6 in the first 5 years to 30.7 in the last 5 years. The mean birthweight decreased from 1873 to 1588 grams. The incidence of IPPV rose from 32.8 to 57.3%. For a separated group artificially ventilated children with gestational ages of greater than or equal to 28 weeks and less than or equal to 33 weeks and with birthweight greater than or equal to 1000 grams and less than or equal to 2499 grams survival increased from 36 to 50% and mean birthweight decreased from 1636 to 1489 grams. Introduction of continuous positive airway pressure (CPAP) did not change either incidence of IPPV or incidence of BPD. The most important determinants of a poor prognosis are low gestational age, low birthweight and necessity of IPPV. The prognosis of the individual patient is improved. The continuously bad prognosis for children with very low birthweight (less than 1000 grams) with HMD makes the search for other ventilation techniques worthwhile.
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