Ventilatory Strategies in Infants with Established Severe Bronchopulmonary Dysplasia: A Multicenter Point Prevalence Study

McKinney, Robin; Napolitano, Natalie; Levin, Jonathan J.; Kielt, Matthew J.; Guamán, Milenka Cuevas; Rose, Rebecca S.; Courtney, Sherry E.; Matlock, David N.; Agarwal, Amit; Leeman, Kristen T.; Sanlorenzo, Lauren A.; Sindelar, Richard; Collaco, Joseph M.; Baker, Christopher D.; Hannan, Kathleen E.; Douglass, Matthew; Eldredge, Laurie C.; Lai, Khanh; McGrath‐Morrow, Sharon A.; Tracy, Michael C.; Truog, William E.; Lewis, Tamorah; Murillo, Anarina L.; Keszler, Martin

doi:10.1016/j.jpeds.2021.10.036

Cited by 17 publications

(14 citation statements)

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“…There remain no prospective, randomized controlled trials that support widespread application of any given respiratory approach. One multi-center point prevalence study evaluated ventilator modes and settings in infants with severe BPD, and as expected significant variation in ventilation setting and mode selection was reported ( 9 ). This variation was noted among sites in the BPD Collaborative, a collective of hospitals with interdisciplinary BPD programs, and is illustrated in Figure 1 ( 9 ).…”

Section: Introductionmentioning

confidence: 87%

“…The risk of death after discharge in patients with severe BPD is likely highest in patients with tracheostomies and a history of BPD-PH ( 20 , 21 ). Infection is also an important cause of both in-hospital and post-discharge mortality in this population ( 9 ).…”

Section: Available Informationmentioning

confidence: 99%

“…There is wide provider variability regarding ventilator mode selection for patients with BPD, even among centers in the BPD Collaborative ( 9 ). Our preference is a pressure synchronized intermittent mandatory ventilation (SIMV) with pressure support mode.…”

Section: Principles Of Respiratory Care Of Infants With Severe Bpdmentioning

confidence: 99%

“…The appropriate level of positive end-expiratory pressure (PEEP) needed for patients with severe BPD remains to be determined, and a wide practice variation exists among centers ( 9 ). Even in the setting of hyperinflation, the set PEEP should be high (≥8 cm H 2 O) to maintain functional residual capacity, avoid atelectasis, and improve gas exchange ( 11 ).…”

Section: Principles Of Respiratory Care Of Infants With Severe Bpdmentioning

confidence: 99%

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Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence

et al. 2022

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Section: Introductionmentioning

confidence: 87%

Section: Available Informationmentioning

confidence: 99%

Section: Principles Of Respiratory Care Of Infants With Severe Bpdmentioning

confidence: 99%

Section: Principles Of Respiratory Care Of Infants With Severe Bpdmentioning

confidence: 99%

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Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence

et al. 2022

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“…In light of many challenges in caring for infants with sBPD, including the absence of high-quality research, there is considerable uncertainty and variation in care strategies for infants with sBPD within and among centers. 23 24 25…”

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confidence: 99%

Approaches to Interdisciplinary Care for Infants with Severe Bronchopulmonary Dysplasia: A Survey of the Bronchopulmonary Dysplasia Collaborative

et al. 2022

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Objective Bronchopulmonary dysplasia (BPD) remains the most common late morbidity for extremely premature infants. Care of infants with BPD requires a longitudinal approach from the neonatal intensive care unit to ambulatory care though interdisciplinary programs. Current approaches for the development of optimal programs vary among centers. Study Design We conducted a survey of 18 academic centers that are members of the BPD Collaborative, a consortium of institutions with an established interdisciplinary BPD program. We aimed to characterize the approach, composition, and current practices of the interdisciplinary teams in inpatient and outpatient domains. Results Variations exist among centers, including composition of the interdisciplinary team, whether the team is the primary or consult service, timing of the first team assessment of the patient, frequency and nature of rounds during the hospitalization, and the timing of ambulatory visits postdischarge. Conclusion Further studies to assess long-term outcomes are needed to optimize interdisciplinary care of infants with severe BPD. Key Points

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Predictors for invasive home mechanical ventilation duration in bronchopulmonary dysplasia

Foster

Noreen

Grage

et al. 2023

Pediatric Pulmonology

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Background: Children with bronchopulmonary dysplasia (BPD) who require invasive home mechanical ventilation (IHMV) are medically vulnerable and experience high caregiving and healthcare costs. Predictors for duration of IHMV in children with BPD remain unclear, which can make prognostication and decision-making challenging.Methods: A retrospective cohort study of children with BPD requiring IHMV was conducted from independent children's hospital records (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021). The primary outcome was IHMV duration, defined as time from initial discharge home on IHMV until cessation of positive pressure ventilation (day and night). Two new variables were included: discharge age corrected for tracheostomy (DACT) (chronological age at discharge minus age at tracheostomy) and level of ventilator support at discharge (minute ventilation per kg per day). Univariable Cox regression was performed with variables of interest compared to IHMV duration. Significant nonlinear factors (p < 0.05) were included in the multivariable analysis.

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Ventilatory Strategies in Infants with Established Severe Bronchopulmonary Dysplasia: A Multicenter Point Prevalence Study

Cited by 17 publications

References 20 publications

Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence

Optimizing ventilator support in severe bronchopulmonary dysplasia in the absence of conclusive evidence

Approaches to Interdisciplinary Care for Infants with Severe Bronchopulmonary Dysplasia: A Survey of the Bronchopulmonary Dysplasia Collaborative

Predictors for invasive home mechanical ventilation duration in bronchopulmonary dysplasia

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