Concurrent and supportive therapies
BPD, respiratory insufficiency, hypotension
RESPIRATORY INSUFFICIENCY, PATHOPHYSIOLOGY
The daily treatment practices of patients enrolled in the study will be performed according to the local guidelines of each center. However, to standardize the most relevant procedures in the participating centers, the fluid intake will be based essentially on changes in body weight, serum electrolyte concentration, and serum osmolality starting indicatively with 70–80 mL/kg and increasing by 10–20 mL/kg/day until reaching approximately 150 mL/kg at the end of the first week of life. Maternal or donor milk will be given from the first day of life; if the infusion of a glucose solution is indicated, the concentration of the latter will be chosen in such a way as to maintain appropriate blood sugar levels; electrolytes will be added only after the first day of life, while the intravenous administration of amino acids and lipids will be undertaken from the first day. In the case of systemic hypotension refractory to fluid therapy, vasoactive drugs will be started depending on the underlying pathophysiology.Newborns will receive antibiotic prophylaxis once blood cultures have been taken, and it will be suspended after 2 or 3 days once results are negative.Postnatal steroid treatment may be administered in infants with severe respiratory insufficiency under maximal mechanical ventilation and at high risk of mortality or in infants with evolving or established BPD.