Neonatal resuscitation and preventive continuous positive pressure ventilation]

One of the aspects of prematurity in neonates is the respiratory distress syndrome. Although treatment with mechanical ventilation reduced the mortality rate, bronchopulmonary dysplasia still develops in many neonates. We have attempted to reduce intubation and mechanical ventilation by using, in the delivery room, humidified and warmed gas with fractional inspired oxygen as low as possible to obtain SaO2 between 85 and 95%. The gas was administered with a face mask using continuous positive air pressure 3-5 cm H2O. Seventeen out of 66 premature neonates born before the 35th week of gestation were ventilated immediately (n = 11) or subsequently (n = 6). Seven out of 26 infants (27%) born between 30 and 32 weeks required mechanical ventilation. In contrast, ventilation was necessary for eight out of 16 premature neonates born before the 29th week of gestation. Mortality rate was 6% (4/66) in the latter group (< 29 weeks), and only one neonate developed bronchopulmonary dysplasia.