Adaptation of ventilation strategies from acute RDS to severe BPD: A national multicenter survey of practices in extremely preterm infants
Advances in diagnostic and therapeutic methods have led to a paradigm shift in the management of bronchopulmonary dysplasia (BPD). The lack of evidence-based data in this area has led to variations in clinical practice. The aim of this study was to identify these differences and compare them with recommendations based on pathophysiology. The study was designed as an observational online survey of neonatologists from level 3 to 4 neonatal intensive care units caring for premature infants at increased risk of BPD and born before 28 weeks' gestation. Respondents were invited to participate in the study through the portal of the Turkish Neonatal Society. Participants were surveyed online about preferred ventilation modes, settings and clinical management of these patients through each respiratory distress syndrome, evolving BPD and severe BPD phases. A total of 39 centers involved in the study. Pressure-control assist-control volume-guaranteed was the most commonly preferred ventilation mode in respiratory distress syndrome and evolving BPD, while high frequency oscillatory ventilation was most commonly used in severe BPD. The use of synchronized intermittent mandatory ventilation volume-guaranteed pressure support ventilation increased with disease progression. Ventilation settings were found to be changed according to pathophysiological recommendations, but not to the extent recommended. The study shows that early ventilation strategies are predominantly maintained in the later phases of BPD, although there are notable differences between centers.
Authors
- Zeynep Alp Ünkar (ORCID: https://orcid.org/0000-0002-4225-4143)
- Sema TANRIVERDİ (ORCID: https://orcid.org/0000-0002-5681-3647)
- İpek Güney Varal (ORCID: https://orcid.org/0000-0002-3298-066X)
- Hasan Özkan (ORCID: https://orcid.org/0000-0003-2542-7441)
- Kadir Şerafettin Tekgündüz (ORCID: https://orcid.org/0000-0001-6375-5644)
- Demet Terek (ORCID: https://orcid.org/0000-0002-0970-6582)
- Ali Bülbül (ORCID: https://orcid.org/0000-0002-3510-3056)
- Tuğba Egeli
- Nuray Duman (ORCID: https://orcid.org/0000-0003-0545-2914)
- Yalçın Çelik (ORCID: https://orcid.org/0000-0002-1357-0585)
- Funda Tüzün (ORCID: https://orcid.org/0000-0001-5348-1168)
- Özmert M.A. Özdemir (ORCID: https://orcid.org/0000-0002-2499-4949)
- Özgün Uygur (ORCID: https://orcid.org/0000-0002-7580-915X)
- Can Akyıldız
- Merih Çetinkaya
- Şebnem Kader (ORCID: https://orcid.org/0000-0001-7585-4228)
- Özgül Bulut (ORCID: https://orcid.org/0000-0001-9939-7375)
- Hasan Kahveci (ORCID: https://orcid.org/0000-0002-7535-5880)
- Gökhan Büyükkale (ORCID: https://orcid.org/0000-0003-3589-1600)
- Hakan Ongun (ORCID: https://orcid.org/0000-0002-4671-4872)
- Mustafa Özdemir (ORCID: https://orcid.org/0000-0002-1359-4181)
- Özkan İlhan (ORCID: https://orcid.org/0000-0002-6124-9796)
- Özlem Bozkurt (ORCID: https://orcid.org/0000-0002-1282-9030)
- Belma Saygılı Karagöl (ORCID: https://orcid.org/0000-0003-3728-9613)
- Nejat Narlı (ORCID: https://orcid.org/0000-0002-0474-3288)
- İstemi Han Çelik (ORCID: https://orcid.org/0000-0002-2952-8154)
- Hasan Çetin (ORCID: https://orcid.org/0000-0002-1273-0233)
- Nuriye Tarakçı (ORCID: https://orcid.org/0000-0003-2444-4725)
- Hilal Özkan (ORCID: https://orcid.org/0000-0001-5454-5119)
- Abdullah Barış Akcan (ORCID: https://orcid.org/0000-0003-0181-1166)
- Melek Büyükeren (ORCID: https://orcid.org/0000-0001-8602-6241)
- Fatih İşleyen (ORCID: https://orcid.org/0000-0002-5015-621X)
- Emel Okulu (ORCID: https://orcid.org/0000-0002-1101-3355)
- Canan Aygün (ORCID: https://orcid.org/0000-0002-7955-5943)
- Ahmet Özdemi̇r (ORCID: https://orcid.org/0000-0002-7572-069X)
- Tülin Gökmen Yıldırım (ORCID: https://orcid.org/0000-0001-5951-2631)
- Dilek Çoban (ORCID: https://orcid.org/0000-0003-4598-3664)
- Hüseyin Şimşek (ORCID: https://orcid.org/0000-0002-3453-6802)
- Zeynel Gökmen (ORCID: https://orcid.org/0000-0002-2746-0547)
- Gözde Kanmaz
- Şenol Bozdağ
- Leyla Karadeniz
Institutions
- Bursa Uludağ Üni̇versi̇tesi̇ (TR)
- Izmir University (TR)
- Ankara University (TR)
- Manisa Celal Bayar University (TR)
- Süleyman Demirel Üniversitesi (TR)
- Başkent University (TR)
- Dokuz Eylül University (TR)
- Akdeniz University (TR)
- Mardin Artuklu University (TR)
- Ondokuz Mayıs University (TR)
- Kırklareli University (TR)
- Ege University (TR)
- Zübeyde Hanim Maternity Hospital (TR)
- Dr. Behçet Uz Çocuk Hastalıkları Hastanesi (TR)
- Necmettin Erbakan University (TR)
- Istanbul University-Cerrahpaşa (TR)
- Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi (TR)
- Erzurum Regional Training and Research Hospital (TR)
- Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi (TR)
- Sağlık Bilimleri Üniversitesi (TR)
- Şişli Etfal Eğitim ve Araştırma Hastanesi (TR)
- İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi (TR)
- S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi (TR)
- Pamukkale University (TR)
- Mersin Üniversitesi (TR)
- Kocaeli Üniversitesi (TR)
- Cukurova University (TR)
- Istanbul Medeniyet University (TR)
- Atatürk University (TR)
- Istanbul University (TR)
- Adnan Menderes University (TR)
- Muğla University (TR)
- Erciyes University (TR)
- Okan University (TR)
Publication Details
- Journal
- Medicine
- Published
- 2025-05-30
- DOI
- https://doi.org/10.1097/md.0000000000041973
- Citations
- 2
- Primary Topic
- Neonatal Respiratory Health Research
- Type
- article
- Field-Weighted Citation Impact
- 3.04