Displasia broncopulmonar en pacientes de un programa madre canguro en Popayán-Colombia. Estudio de cohorte retrospectivo

Abstract

Kangaroo-Mother Care (KMC) is a follow-up program for premature infants with comorbidities such as bronchopulmonary dysplasia (BPD). The objective was to characterize patients with BPD and describe their nutritional, neurological, and respiratory outcomes in a KMC. A retrospective cohort study of the KMC in a University Hospital between 2015-2018. Included patients with BPD and excluded major malformations. Nutritional, neurological, and respiratory outcomes were evaluated at 40 weeks, 6, and 12 months of corrected-age using scales recommended in Colombia. A descriptive analysis was carried out, the variables were compared according to the severity of BPD. The changes in the outcomes in patients with complete follow-up were evaluated. 490 patients were admitted in four years, 50 with BPD (10,2%); 58% with moderate-BPD, none with severe BPD. 46% were born at <29 weeks of gestational-age, 96% had low socioeconomic status and 90% and 90% of these submitted to mechanical ventilation. In the follow-up, height-for-age remained at risk at 6 and 12 months. 98% had abnormal Amiel-Tisson test. Around 75% had respiratory symptoms between 6 and 12 months and 33% had at least one hospital readmission. Patients with BPD in KMC have alterations in height-for-age, neurodevelopment, and respiratory system when complete the follow-up.

Alternate abstract:

El Programa Madre Canguro (PMC) permite un seguimiento a prematuros con comorbilidades como displasia broncopulmonar (DBP). El objetivo fue caracterizar los pacientes con DBP, describir su compromiso nutricional, neurológico, respiratorio en un PMC. Se realizó un estudio de cohorte retrospectivo en el PMC de un Hospital Universitario con aprobación del comité de ética. Incluyó pacientes con DBP entre 2015-2018, sin malformaciones mayores. Evaluamos el estado nutricional, neurológico y respiratorio a las 40 semanas, 6 y 12 meses de edad corregida mediante escalas recomendadas en Colombia. Realizamos análisis descriptivo y comparación según severidad de la DBP. Describimos la evolución en pacientes con seguimiento completo. Ingresaron 490 pacientes en cuatro años, 50 con DBP (10,2%); 58% con DBP-moderada, ninguno con DBP-severa. 96% de estrato socioeconómico bajo, 46% <29 semanas de edad gestacional y el 90% sometidos a ventilación mecánica. Encontramos compromiso del promedio de Talla/Edad a 6 y 12 meses. Prueba Amiel Tisson anormal en 98%. Cerca del 75% presentaron síntomas respiratorios entre 6 y 12 meses y 33% tuvo al menos un reingreso hospitalario. Los pacientes con DBP del PMC tienen compromiso en la Talla/Edad, neurodesarrollo y alteraciones respiratorias al completar el seguimiento.