Posted on February 27, 2002 at 4:40 p.m.

BIRMINGHAM, AL — UAB’s gentle ventilator practices for tiny premature babies have helped establish it as one of the top neonatal units in the country, particularly in its low incidence of bronchopulmonary dysplasia.

Bronchopulmonary dysplasia is a chronic lung disease that can occur in newborn babies when the lungs become injured. It is especially common among babies born prematurely with underdeveloped and immature lungs and is one of the most common adverse outcomes of prematurity.

Now, other top centers in the country will attempt to mimic UAB’s ventilator and intensive care practices as part of a three-year study to reduce the incidence of BPD nationwide.

A total of 17 highly acclaimed neonatal research centers will participate in the study. The centers are all part of the NICHD Neonatal Research Network, which maintains an extensive registry on the treatments and outcomes of more than 35,000 very low birth weight babies.

Infants of very low birth weight, 3.3 pounds or less, account for 1 percent of all U.S. births, or about 40,000 births per year. Waldemar Carlo, M.D., lead investigator of the UAB portion of the study and director of the UAB Regional Neonatal Intensive Care Unit (RNICU), said lung injury occurs in 60 percent of babies that are born weighing less than about 3 1/2 pounds, which typically occurs when a baby is born about two months prematurely or when there are multiple births involved. And he said about 10 percent of all births in the country are premature births.

After five years of extensive data collection, UAB, Brown University and University of Miami have the lowest incidence of this common lung disorder among the 17 in the network. Those three nurseries will serve as benchmarks for the remaining 14, which will be broken into seven control centers and seven experimental centers.

The hypothesis behind the study is that by following guidelines of practice set by the three benchmark nurseries, the seven experimental centers will have a much lower incidence of BPD after three years, compared with the control centers (that will not change their practices to match the guidelines).

“It is still not known what causes the lungs of premature babies to become injured, but it is believed to be caused by a combination of many factors,” Carlo said. “We are hoping this study will help us narrow things down and be able to provide all hospitals with a set of guidelines on how to avoid injuries.”

Carlo said once it was determined that UAB would lead as a benchmark nursery, teams of doctors, nurses and respiratory therapists met to determine some of the reasons for the low incidence.

“The consensus among each of the groups independently was that it is the way we use our ventilators,” Carlo said. “We use them in a more gentle way using a technique called gentle venting or minimal venting. It is a technique that was developed here for babies and independently by other physicians who treat adults in other parts of the country. It has been proven to cause less lung injury.

“We are very excited to be participating as a benchmark nursery in this study,” he said. “It means that we do a very good job and that we give the best pulmonary care in the nation. It also tells us that, using a team approach, we are improving the pulmonary outcome of these babies. And these babies need a lot of help. Pulmonary care is the most critical aspect of neonatal care; and one of the most important because it is usually the sickest babies who need pulmonary care.”