Improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates who have received antenatal steroids and surfactant

Aims-To assess survival and neurodevelopmental outcome following prolonged ventilation beyond 27 or 49 days of postnatal life in neonates treated with antenatal steroids and surfactant. Methods-The medical records of 84 babies born in 1994-1996 requiring ventil ation after 27 postnatal days at Liverpool Women's Hospital were reviewed t o determine the duration of mechanical ventilation, survival, and neurodeve lopmental outcome at 3 years of age. Results-Fifty six babies were mechanically ventilated after 27 postnatal da ys but for less than 50 days; 48 (86%) survived to 3 years. Twenty six (54% ) of the survivors had normal neurodevelopment at 3 years and seven (15%) h ad only mild disability. Twenty eight babies were ventilated after 49 postn atal days; 14 survived to 3 years. Five of these survivors were neurodevelo pmentally normal at 3 years and two had mild disability. Conclusions-Survival decreases with more prolonged ventilation. When antena tal steroids and postnatal surfactant are used, there appears to be improve d survival and neurodevelopmental outcome in preterm babies who require pro longed ventilation.