Management of infants with chronic lung disease of prematurity in Chile

Abstract

Despite advances in the prevention and management of respiratory distress syndrome, chronic lung disease of prematurity (CLD) remains a major cause of morbidity and mortality in preterm babies in Chile. Its incidence varies from 10% to 60% in different regions of Chile. Since 1998, the management of CLD after discharge from neonatal unit follows national guidelines. Target oxygen saturation is 85% to 91% in the first week of life, 91% to 94% from 1 to 2 weeks and over 95% after 44 weeks postconceptional age. National home oxygen program has improved outcome in infants with CLD. Other specific treatments are used with caution. Diuretics are used for pulmonary oedema. The adverse neurological outcome in infants treated with postnatal steroids restricts its use to infants who cannot be weaned from mechanical ventilation. Inhaled steroids and bronchodilators may reduce asthma-like symptoms in established CLD. Prevention of RSV infection in CLD babies is paramount. The preterm infant population has been maintained under surveillance nationally since 1998.