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- CLD =
- chronic lung disease •
- VLBWI =
- very low birth weight infant •
- NP-CPAP =
- nasal prongs continuous positive airway pressure •
- ELBWI =
- extremely low birth weight infant •
- CPAP =
- continuous positive airway pressure •
- HMD =
- hyaline membrane disease
The recent article by Van Marter et al,1 discussing the association between barotrauma, oxygen toxicity, and chronic lung disease (CLD) in the very low birth weight infant (VLBWI) weighing <1500 g was of great interest. They observed a significantly lower incidence of CLD in the VLBWI at Children's Hospital of New York–Columbia University compared with 2 other centers affiliated with Harvard University in Boston. The difference in incidence of CLD was wide, 4% versus 22%. The lower incidence of CLD was true for all gestational age and birth weight subcategories. Columbia University is recognized for its strategy of early use of nasal prongs continuous positive airway pressure (NP-CPAP).2 The association of low incidence of CLD and the use of NP-CPAP was reported earlier in 1987 by Avery et al.2 This association was confirmed in a survey of other 11 American neonatal centers.3 In Sweden, a citywide survey in neonatal units in Stockholm confirmed the feasibility of the early use of NP-CPAP.4
The early use of NP-CPAP is not only successful in the VLBWI, but also in the extremely low birth weight infant (ELBWI) weighing <1000 g. In September 1997, at the George Washington University Department of Newborn Service we emphasized the use of NP-CPAP as the primary mode of respiratory support in all premature …
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