Affiliations: Departments of Children's National Medical Center,
Washington DC U.S.A. | Departments of Infant and Child Development,
Children's National Medical Center, Washington DC U.S.A. | Department of Newborn Services, George Washington
University Medical Center, Washington DC U.S.A.
Note: [] Correspondence: Hany Aly, M.D., The George Washington University
Hospital 900 23rd street, NW, Suite G-2092, Room G-132 Washington, DC 20037,
U.S.A. Tel: (202) 715-5236, fax (202) 715-5354. E-mail: haly@mfa.gwu.edu
Abstract: At our institution a policy of early nasal continuous positive
airway pressure (ENCPAP) in extremely low birth weight (ELBW) infants has been
followed during the past 5 years. Routine intubation and surfactant
administration is no longer our practice. The impact of this policy on infant
outcomes is under investigation. This is a retrospective review of ELBW infants
(< 1000 g) born at our institution between January 1998 and July 2002. Data
on hearing deficits, visual impairment and Bayley scores at 3–6 months of
corrected age were analyzed. Ninety-two ELBW infants were identified. Sixteen
(17.4%) infants died and 14 (15.2%) ELBW were transferred to another
institution. For the 62 survivors discharged home, mean gestational age was
26.4 ± 1.6 wks and birth weight was 797±129 g. The majority (67%)
of these ELBW infants were managed with ENCPAP. Three (10.3%) infants had
abnormalities on hearing evaluation. Three (4.8%) infants had retinopathy of
prematurity requiring laser. Thirty infants were followed up developmentally.
Four of these infants had normal neurodevelopmental evaluation at 6–8 weeks
corrected age, and did not return for further follow-up. Twenty-six infants
were followed at least through the three to six month visit. Six (23%) remained
on high calorie formula with four (14%) infants requiring nasogastric tube
feeding. Seven (25%) infants had Bayley mental developmental index < 70
(< 2 SD) and seven (25%) infants had Psychomotor Developmental Index <
70. Neurodevelopmental morbidity remains a concern for ELBW infants managed
with ENCPAP. Although these results are subject to selection bias, the rates of
neurodevelopmental morbidity are similar to those reported in the recent
literature. (J Pediatr Neurol 2004; 2(3): 149–152).
