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 17/ISSUE 5, SEPTEMBER 2021

Problems and perceptions around severe bronchopulmonary dysplasia

Advances in neonatal care have led to increased survival of the extreme preterm infant, yet bronchopulmonary dysplasia (BPD) as a comorbidity has shown an increasing trend. A major proportion of preterm infants who remain invasively ventilated at term-corrected gestational age go on to require long-term respiratory support yet the management and prognosis for severe BPD shows wide regional variation depending on availability of resources. This article addresses conundrums regarding the management of severe BPD and the care pathway, including a survey of practice to give a UK regional perspective.