AIM To evaluate if increased survival and new ventilation strategies were accompanied by a changed incidence of bronchopulmonary dysplasia (BPD) in Sweden over a decade. METHODS Data from two Swedish population-based studies of live-born infants with gestational ages (GA) 22-26 weeks, born during 2004-2007 (n=702) and 2014-2016 (n=885), were compared for survival, any BPD, moderate BPD, severe BPD, and BPD/severe BPD or death at 36 weeks postmenstrual age (PMA). Ventilation strategies and interventions were analysed. Any BPD was defined as the use of supplemental oxygen or any respiratory support at 36 weeks PMA, moderate BPD as nasal cannula with <30% oxygen, and severe BPD as ≥30% oxygen, CPAP, or mechanical ventilation. RESULTS Survival to 36 weeks PMA increased from 72% to 81%(p<0.001). Total days on mechanical ventilation increased from a median of 9 to 16 days (p<0.001). The high-flow nasal cannula (HFNC) was introduced between the cohorts, and days of CPAP and HFNC increased from 44 to 50 days (p<0.001). Any BPD was unchanged, 65% versus 68%. Moderate BPD increased from 37% to 47%(p=0.003), while incidence of severe BPD decreased from 28% to 23%(p<0.046). Severe BPD or death decreased from 48% to 37%(p<0.001) while any BPD or death remained unchanged at 74 versus 75%. CONCLUSION Even though an increased survival of infants born at 22-26 weeks GA was accompanied by an increased duration of invasive and non-invasive respiratory support, the incidence of any BPD remained unchanged while severe BPD decreased in infants alive at 36 weeks PMA.

中文翻译：

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2004-2007 年和 2014-2016 年瑞典妊娠 22-26 周出生婴儿的呼吸支持和支气管肺发育不良。


目的 评估十年来瑞典生存率的提高和新的通气策略是否伴随着支气管肺发育不良 （BPD） 发病率的变化。方法 来自瑞典两项基于人群的研究数据，研究对象是 2004-2007 年 （n=702） 和 2014-2016 年 （n=885） 出生的胎龄 （GA） 22-26 周活产婴儿，比较生存率、任何 BPD、中度 BPD、重度 BPD 和 BPD/重度 BPD 或胎龄 36 周 （PMA） 死亡。分析了通气策略和干预措施。任何 BPD 定义为在 PMA 36 周时使用补充氧气或任何呼吸支持，中度 BPD 定义为含氧量为 <30% 的鼻插管，重度 BPD 定义为 ≥30% 氧气、CPAP 或机械通气。结果 36 周 PMA 生存率从 72% 增加到 81%（p<0.001）。机械通气总天数从中位数 9 天增加到 16 天 （p<0.001）。在队列之间引入高流量鼻插管 （HFNC），CPAP 和 HFNC 的天数从 44 天增加到 50 天 （p<0.001）。任何 BPD 均保持不变，分别为 65% 对 68%。中度 BPD 从 37% 增加到 47%（p=0.003），而重度 BPD 的发生率从 28% 下降到 23%（p<0.046）。严重 BPD 或死亡从 48% 下降到 37%（p<0.001），而任何 BPD 或死亡保持不变，分别为 74% 和 75%。结论 尽管 22-26 周出生的婴儿 GA 存活率增加，但有创和无创呼吸支持的持续时间增加，任何 BPD 的发生率保持不变，而 36 周 PMA 存活婴儿的严重 BPD 发生率降低。