Disproportionate Consumption Of Ventilator Resources by Very Preterm Survivors Persists in the 1990s

ABSTRACT

The aim of this study of consecutive livebirths between 23 and 30 weeks of gestational age was to determine the changes over time in the relationship between gestational age and the consumption of nursery resources by surviving preterm infants. Three discrete eras, comprising the years 1977-1985, 1986-1990, and 1991-1995, were identified, based on availability of ventilators and changes in perinatal care. The survival rate rose dramatically with each week's increase in gestational age, and increased significantly between successive eras. Overall, consumption of resources for assisted ventilation by survivors increased over time. In infants born before 28 weeks, for each week of decrease in gestational age, survivors averaged an extra 12.9 days of assisted ventilation in 1977-1985, 13.4 days in 1986-1990, and 13.5 days in 1991-1995, while infants born between 28-30 weeks of gestational age needed only an extra 2.3 days, 3.3 days, and 4.6 days of assisted ventilation for each week of decrease in gestational age in successive eras, respectively. There was no indication that improvements in perinatal care over time shortened the duration of assisted ventilation for surviving preterm infants.

Keywords

Infant - newborn - preterm - assisted ventilation - survival