Peter Krcho, Katarína Vilčeková, Viktória Hudáková, Zuzana Gajdošová
Objective: The effective prevention of bronchopulmonary dysplasia (BPD) requires comprehension of the possible side effects of various interventions. Authors suggest that BPD may result from not only prematurity, ventilation strategies, and cytokinerelated lung injury, but also from management during the transition period, fluid and energy intake, and mineral homeostasis and other. Material & methods: The authors compared weight gain and mineral homeostasis in 50 newborns under 1500 g during the 30 day period after delivery while they were treated in the neonatal intensive care unit Košice during 2006. The data collected were weight gain, and serum levels of Na and K, the incidence of complications, days of mechanical ventilation, and days of bubble CPAP. After the data collection period, the newborns were divided to two groups based on the presence or absence of BPD. Data were analyzed by multi-regression analysis, with significance if p < 0,05. Results: The occurrence of BPD in the whole group was 24 %. Newborns with BPD had lower birth weight and gestational age, more days of ventilation, and had also slower weight gain. The weight during the first seven days decreased significantly in newborns with BPD, and the newborns with BPD were able to regain birth weight at a mean age of 24 days, while the newborns without BPD did so on at an average of 15 days. The average daily weight gain was significantly higher in newborns without BPD. The level of sodium on the 7th day was significantly lower in newborns without BPD, the level of potassium on 7th day was significantly lower in newborns with BPD, the levels of sodium and potassium from the 7th until the 30th day of life were not significantly different in the two groups. Conclusion: Future research in this area might be directed toward refining the critical period during which water intake must be controlled in order to achieve a reduction in BPD, although there are clear protocols for the management. It would also be valuable to develop models for predicting optimal water and mineral balance in which the most important determinants are taken into account, such as birth weight, gestational age, postnatal age, and ambient humidity. Finally, future studies should target the most vulnerable group for BPD, extremely premature infants, and what is most important for them – ventilation strategy, fluid and mineral homeostasis, infection, and cytokine-mediated injury, among others.