TY - JOUR T1 - Invasive mechanical ventilation and biomarkers as predictors of bronchopulmonary dysplasia in preterm infants JO - Jornal de Pediatria (English Edition) T2 - AU - Nascimento,Camila Piqui AU - Maia,Larissa Prado AU - Alves,Patrícia Terra AU - Paula,Aline Teodoro de AU - Cunha Junior,Jair Pereira AU - Abdallah,Vânia Olivetti Steffen AU - Ferreira,Daniela Marques de Lima Mota AU - Goulart,Luiz Ricardo AU - Azevedo,Vivian Mara Gonçalves de Oliveira SN - 00217557 M3 - 10.1016/j.jped.2020.03.006 DO - 10.1016/j.jped.2020.03.006 UR - https://jped.elsevier.es/en-invasive-mechanical-ventilation-biomarkers-as-articulo-S0021755720301443 AB - ObjectivesTo evaluate the impact of invasive mechanical ventilation associated with two serum inflammatory cytokines and clinical indicators, on the second day of life, as predictors of bronchopulmonary dysplasia in very low birth weight preterm infants. It was hypothesized that the use of invasive mechanical ventilation in the first hours of life is associated with biomarkers that may predict the chances of preterm infants to develop bronchopulmonary dysplasia. MethodsProspective cohort of 40 preterm infants with gestational age <34 weeks and birth weight <1500 g. The following were analyzed: clinical variables; types of ventilator support used (there is a higher occurrence of bronchopulmonary dysplasia when oxygen supplementation is performed by long periods of invasive mechanical ventilation); hospitalization time; quantification of two cytokines (granulocyte and macrophage colony stimulating factor [GM-CSF] and eotaxin) in blood between 36 and 48 h of life. The preterm infants were divided in two groups: with and without bronchopulmonary dysplasia. ResultsThe GM-CSF levels presented a significantly higher value in the bronchopulmonary dysplasia group (p = 0.002), while eotaxin presented higher levels in the group without bronchopulmonary dysplasia (p = 0.02). The use of continuous invasive mechanical ventilation was associated with increased ratios between GM-CSF and eotaxin (100% sensitivity and 80% specificity; receiver operating characteristic area = 0.9013, CI = 0.7791–1.024, p < 0.0001). ConclusionsThe duration of invasive mechanical ventilation performed in the first 48 h of life in the very low birth weight infants is a significant clinical predictor of bronchopulmonary dysplasia. The use of continuous invasive mechanical ventilation was associated with increased ratios between GM-CSF and eotaxin, suggesting increased lung injury and consequent progression of the disease. ER -