Characteristics and outcome of infants with bronchopulmonary dysplasia established on long-term ventilation from neonatal intensive care
Characteristics and outcome of infants with bronchopulmonary dysplasia established on long-term ventilation from neonatal intensive care
Introduction: Ex-preterm infants with severe bronchopulmonary dysplasia (BPD) sometimes require long-term ventilation (LTV) to facilitate weaning from respiratory support. There are however limited data characterizing this cohort. We aim to describe the background characteristics, neonatal comorbidities, characteristics at the initiation of ventilation, and outcomes of neonatal unit graduates with BPD established on LTV. Methods: A retrospective cohort study of infants born <32 weeks gestation with BPD referred to a regional LTV service between January 2015 and December 2020. Results: Twenty-five infants were referred during the study period. Median birth gestation was 26 + 1 weeks (24 + 0–30 + 4) and birth weight 645 g (430–1485). At 36 weeks postmenstrual age (PMA), median FiO2 was 0.45 (0.24–0.80) and one-quarter of infants remained on invasive ventilation. Twenty (80%) infants were established on noninvasive ventilation (NIV), with the smallest weighing 2085 g, and five (20%) required tracheostomy invasive ventilation (TIV). At initiation of NIV/TIV, median PMA was 41 + 1 weeks and median FiO2 0.40 (0.29–0.80). Infants established on TIV spent almost five times longer in hospital before discharge compared to those on NIV (p = 0.003). By March 2022, 18 (72%) infants had discontinued ventilation, spending a median total time of 113 days (18–1792) on ventilation. Conclusion: Due to advances in interfaces, headgear, and ventilator technology, NIV is an attractive and practically achievable option for infants with severe BPD as small as 2 kg. Initiation and weaning should take place in a facility with the required multidisciplinary expertize.
infant entilator weaning, noninvasive ventilation, premature, ronchopulmonary dysplasia, tracheostomy
2614-2621
Ong, Jonathan Wen Yi
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Everitt, Lucy
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Hiscutt, Jodie
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Griffiths, Catherine
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McEvoy, Alison
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Goss, Kevin Colin William
f81fb1f2-e427-459f-ba21-605eeda37640
Johnson, Mark John
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Evans, Hazel J.
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November 2022
Ong, Jonathan Wen Yi
ad0f6e2e-58cf-48c7-ba7a-5de7bc8f3964
Everitt, Lucy
e0e992cb-9897-44d9-84db-ec385f8c8b2c
Hiscutt, Jodie
feb670ff-3208-4a9e-9da7-93b99e509908
Griffiths, Catherine
ffdcb5c0-b61a-4599-bd4e-43d0ac2b696d
McEvoy, Alison
40be59d5-85ac-4ccf-8fce-5e20b7c9f38e
Goss, Kevin Colin William
f81fb1f2-e427-459f-ba21-605eeda37640
Johnson, Mark John
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Evans, Hazel J.
11506bb3-ce57-41fa-9966-0b22131a1a35
Ong, Jonathan Wen Yi, Everitt, Lucy, Hiscutt, Jodie, Griffiths, Catherine, McEvoy, Alison, Goss, Kevin Colin William, Johnson, Mark John and Evans, Hazel J.
(2022)
Characteristics and outcome of infants with bronchopulmonary dysplasia established on long-term ventilation from neonatal intensive care.
Pediatric Pulmonology, 57 (11), .
(doi:10.1002/ppul.26072).
Abstract
Introduction: Ex-preterm infants with severe bronchopulmonary dysplasia (BPD) sometimes require long-term ventilation (LTV) to facilitate weaning from respiratory support. There are however limited data characterizing this cohort. We aim to describe the background characteristics, neonatal comorbidities, characteristics at the initiation of ventilation, and outcomes of neonatal unit graduates with BPD established on LTV. Methods: A retrospective cohort study of infants born <32 weeks gestation with BPD referred to a regional LTV service between January 2015 and December 2020. Results: Twenty-five infants were referred during the study period. Median birth gestation was 26 + 1 weeks (24 + 0–30 + 4) and birth weight 645 g (430–1485). At 36 weeks postmenstrual age (PMA), median FiO2 was 0.45 (0.24–0.80) and one-quarter of infants remained on invasive ventilation. Twenty (80%) infants were established on noninvasive ventilation (NIV), with the smallest weighing 2085 g, and five (20%) required tracheostomy invasive ventilation (TIV). At initiation of NIV/TIV, median PMA was 41 + 1 weeks and median FiO2 0.40 (0.29–0.80). Infants established on TIV spent almost five times longer in hospital before discharge compared to those on NIV (p = 0.003). By March 2022, 18 (72%) infants had discontinued ventilation, spending a median total time of 113 days (18–1792) on ventilation. Conclusion: Due to advances in interfaces, headgear, and ventilator technology, NIV is an attractive and practically achievable option for infants with severe BPD as small as 2 kg. Initiation and weaning should take place in a facility with the required multidisciplinary expertize.
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e-pub ahead of print date: 19 July 2022
Published date: November 2022
Additional Information:
Funding Information:
We would like to acknowledge the infants and families who were included in this retrospective cohort study.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
Keywords:
infant entilator weaning, noninvasive ventilation, premature, ronchopulmonary dysplasia, tracheostomy
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Local EPrints ID: 477774
URI: http://eprints.soton.ac.uk/id/eprint/477774
ISSN: 8755-6863
PURE UUID: 614e3546-0528-42ef-9eaa-4affa3e1da70
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Date deposited: 14 Jun 2023 16:38
Last modified: 18 Mar 2024 03:47
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Author:
Jonathan Wen Yi Ong
Author:
Lucy Everitt
Author:
Jodie Hiscutt
Author:
Catherine Griffiths
Author:
Alison McEvoy
Author:
Kevin Colin William Goss
Author:
Mark John Johnson
Author:
Hazel J. Evans
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