Mechanical Ventilation and Survival Without Major Morbidity in Very-Low-Birth-Weight Infants: A Multicenter Study.

Background: Mechanical ventilation (MV) is a frequent lifesaving therapy in very low birthweight (VLBW) infants, although it poses risks and may present complications. Objective: To evaluate the association between the use and duration of MV and survival without major morbidity (SWMM) in VLBW infants according to gestational age (GA). Methods: Multicenter retrospective study of prospectively collected data of premature infants weighing 500-1500 g and 24-30 weeks of GA, born between 2010 and 2019 at NEOCOSUR Neonatal Network centers. Baseline characteristics and neonatal outcomes were compared between ventilated and nonventilated VLBW infants. Stratification for each week of GA was performed. Adjusted odds ratios and 95% confidence intervals (CIs) were calculated for main outcomes by logistic regression, adjusted for birthweight, GA, sex, mode of delivery, respiratory distress syndrome (RDS), antenatal corticosteroids, small for gestational age (SGA), and Apgar scores. Infants with congenital anomalies and those who died before discharge were excluded. Results: A total of 7040 infants were included in the analysis. Among these, 4993 (70.9%) were ventilated and 2047 (29.1%) were not. Nonventilated infants were larger, healthier at birth, and presented fewer major adverse outcomes ( Conclusions: The use and duration of MV were associated with a significant decrease in SWMM in this population of VLBW infants, despite risk adjustment.