The impact of ventilatory support and oxygen therapy in moderate to late pre-term infants on developmental outcomes

Moderate and late pre-term (MPT/LPT) infants are often classified under universal care with allied health professionals’ (AHP) guidelines varying across the UK. Respiratory support impacts development in extremely pre-term as well as critically ill full-term infants requiring ventilation and may result in higher risk of cramped synchronised movements in MPT and LPT infants. Infants who required an increased duration of respiratory support would potentially benefit from AHP input due to the risk of the impact on development regardless of gestational age at birth. The authors review the impact of respiratory support in infants born 30⁺⁰ to 36⁺⁶ weeks’ gestation on developmental outcomes up to five years of age.

Jenny Buck
Clinical Lead Physiotherapist
jenny.buck2@nhs.net

Dr Deepa Shastry
Consultant Paediatrician

Pinderfields Hospital, Mid Yorkshire Hospitals Teaching Trust

Dr Adam Galloway
Advanced Practice Clinical Academic Physiotherapist, Children’s Orthopaedics, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds

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Keywords

pre-term infant; ventilation; respiratory support; child development

Key points

Respiratory support is known to impact developmental outcomes in extremely pre-term infants.
Increased duration of respiratory support has a negative impact up to two years of age in all areas of development and ongoing impact on language and social development until four years of age.
Further research is required to identify the duration of respiratory support that impacts short- and long-term outcomes.

Also published in Infant:

VOLUME 18 ISSUE 6/NOVEMBER 2022

pCO₂ variation in elective transfers of infants on non-invasive respiratory support

Repatriations to local care are an integral part of the remit of neonatal transport teams, with a significant proportion of these infants being transferred on non-invasive respiratory support. A routine blood gas on arrival at the receiving unit is part of our team’s current practice for elective repatriations of infants on non-invasive respiratory support. Through retrospective review of data from a large number of patients transferred, we aimed to determine if there was a significant change in the partial pressure of carbon dioxide (pCO₂) on arrival at the receiving unit, and to identify a subgroup of infants most at risk of an increase in pCO₂.