Background Continuous positive airway pressure (CPAP) is associated with marginal decrease in chronic lung disease (CLD). This study aims to report outcomes, with focus on CLD, of preterm infants managed with a bubble CPAP (b-CPAP) bundle of care. Methods Infants <1500 g were stratified into four groups depending on intubation status through first 3 days of life. The incidence of mortality, CLD and other morbidities were compared over four chronological epochs. Outcomes of the most recent epoch were compared to contemporaneous benchmarks from Vermont Oxford Network (VON). Results Of 773 infants (median GA = 28 weeks, average BW = 995 g), 24.5% were intubated in DR and 11.7% in the first day of life. Mechanical ventilation, bCPAP and oxygen days in survivors were 1.5, 29 and 14, respectively. Overall incidence of CLD was 6.4% that remained consistent in the four epochs (7.6%, 7.5%, 5.8% and 5%), respectively. In comparison to VON, CLD was significantly less ( p < 0.001). Initial DR intubation was not associated with increased CLD compared to initial management with CPAP that required subsequent intubation. Conclusion It is feasible and sustainable to administer a b-CPAP bundle of care to decrease CLD. Cluster randomized trials are needed to validate the reproducibility of this approach.

中文翻译：

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气泡式 CPAP 套装的体验：慢性肺病可以预防吗？

背景持续气道正压通气 (CPAP) 与慢性肺病 (CLD) 的边缘减少有关。本研究旨在报告采用气泡式 CPAP (b-CPAP) 护理包管理的早产儿的结果，重点是 CLD。方法 根据生命最初 3 天的插管状态，将 <1500 g 的婴儿分为四组。死亡率、CLD 和其他发病率的发生率在四个年代进行了比较。最近一个时期的结果与来自佛蒙特州牛津网络 (VON) 的同期基准进行了比较。结果 在 773 名婴儿（中位 GA = 28 周，平均 BW = 995 g）中，24.5% 的婴儿在 DR 时插管，11.7% 在生命的第一天插管。幸存者的机械通气、bCPAP 和吸氧天数分别为 1.5、29 和 14。CLD 的总发病率为 6。4% 分别在四个时期（7.6%、7.5%、5.8% 和 5%）中保持一致。与 VON 相比，CLD 显着降低（p < 0.001）。与需要后续插管的 CPAP 初始管理相比，初始 DR 插管与 CLD 增加无关。结论 实施 b-CPAP 一揽子护理以减少 CLD 是可行且可持续的。需要集群随机试验来验证这种方法的可重复性。