Factors associated with liberation from home mechanical ventilation and tracheostomy decannulation in infants and children with severe bronchopulmonary dysplasia. J Perinatol 2024 Jul 31
Date
08/01/2024Pubmed ID
39085436DOI
10.1038/s41372-024-02078-zScopus ID
2-s2.0-85200110505 (requires institutional sign-in at Scopus site)Abstract
OBJECTIVE: To identify factors associated with the timing of ventilator liberation and tracheostomy decannulation among infants with severe bronchopulmonary dysplasia (sBPD) who required chronic outpatient invasive ventilation.
STUDY DESIGN: Multicenter retrospective study of 154 infants with sBPD on outpatient ventilators. Factors associated with ventilator liberation and decannulation were identified using Cox regression models and multilevel survival models.
RESULTS: Ventilation liberation and decannulation occurred at median ages of 27 and 49 months, respectively. Older age at transition to a portable ventilator and at discharge, higher positive end expiratory pressure, and multiple respiratory readmissions were associated with delayed ventilator liberation. Surgical management of gastroesophageal reflux was associated with later decannulation.
CONCLUSIONS: Ventilator liberation timing was impacted by longer initial admissions and higher ventilator pressure support needs, whereas decannulation timing was associated with more aggressive reflux management. Variation in the timing of events was primarily due to individual-level factors, rather than center-level factors.
Author List
Agarwal A, Manimtim WM, Alexiou S, Abman SH, Akangire G, Aoyama BC, Austin ED, Baker CD, Bansal M, Bauer SE, Cristea AI, Dawson SK, Fierro JL, Hayden LP, Henningfeld JK, Kaslow JA, Lai KV, Levin JC, McKinney RL, Miller AN, Nelin LD, Popova AP, Siddaiah R, Tracy MC, Villafranco NM, McGrath-Morrow SA, Collaco JMAuthors
Sara K. Dawson MD Assistant Professor in the Pediatrics department at Medical College of WisconsinJennifer Henningfeld MD Associate Professor in the Pediatrics department at Medical College of Wisconsin