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\begin{document}

\title{Trends in Ventilation Modes in The Last Decade and Their Impact on The
Incidence of Bronchopulmonary Dysplasia in Preterm Infants}



\author[1]{Tehila Adler-Haltovsky}%
\author[1]{Alex Gileles-Hillel}%
\author[1]{Ira Erlichman}%
\author[1]{smadar Eventov-Friedman}%
\affil[1]{Hebrew University of Jerusalem Faculty of Medicine}%


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  \date{May 24, 2024}


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\begin{abstract}
\textbf{Background:} Less invasive forms of ventilation have evolved
aiming to decrease bronchopulmonary Dysplasia (BPD) morbidity. It is
unclear whether changes in ventilation practices have been associated
with improvements in respiratory outcomes. \textbf{Objective:} To
examine trends of ventilation modes in preterm neonates over the last
decade and their impact on BPD. \textbf{Methods:} A retrospective chart
review of very low birth weight infants (VLBW) and those born at less
than 32 weeks gestation hospitalized during two periods: the years
2012-2013 and 2018-2019. The primary outcome was the prevalence of BPD.
Study variables included the mode and duration of ventilation, duration
of oxygen need, and perinatal clinical parameters. \textbf{Results:}
Four hundred eighty-one infants were enrolled. Between the two study
periods, a significant increase was observed in invasive (33\% to 47\%,
\emph{p}=0.002), and non-invasive ventilation rates (44\% to 72\%,
\emph{p}\textless{}0.001). The average duration of non-invasive
ventilation increased significantly (from 9.24 to 14.08 days,
\emph{p}=0.016). The total duration of respiratory support remained
unchanged. The overall prevalence of moderate and severe BPD at 36 weeks
corrected age remained approximately 40\% in preterm infants born at
less than 28 weeks gestation. \textbf{Conclusion:} The increasing use of
non-invasive ventilation was not accompanied by a reduction in the use
of invasive ventilation, nor by a reduced prevalence of BPD. The high
prevalence of BPD remains a significant problem in preterm infants born
\textless{} 28 weeks of age. Other interventions, in addition to less
aggressive ventilation, need to be explored.%
\end{abstract}%



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