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

Abstract

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

A clinical informatics approach to bronchopulmonary dysplasia: current barriers and future possibilities

“…Some centers have a standardized approach for deciding when to attempt extubation or consider tracheostomy for patients with severe BPD. In the Bronchopulmonary Dysplasia collaborative, only five of the 15 institutions (33%) have a ventilator weaning protocol or extubation protocol ( 70 ). Artificial intelligence-based algorithms, such as ML models, may assist in suggesting ventilator weaning strategies, predicting extubation success, or the probability of long-term mechanical ventilation.…”

“…Due to center-specific variations in patient care and outcomes, multi-center collaborations are necessary to advance our understanding of the disease, identify best practices, and improve patient outcomes ( 1 , 70 , 100 ). Multi-center collaborations offer numerous benefits in BPD research, including a better understanding of disease mechanisms, lung repair, and regeneration.…”

ATS core curriculum 2023. Pediatric pulmonary medicine: Respiratory disorders in infants

“…1 This progress is attributable to evidencebased improvements in prenatal care and neonatal intensive care unit practices, surfactant replacement, as well as targeted diagnostics and therapeutics including access to precision genetic testing, and specialized multidisciplinary care. 2,3 In this review, we highlight common respiratory disorders that affect infants and require the involvement of pediatric pulmonologists and sleep specialists. Each section provides a concise review with relevant clinical and research updates of the following diseases of infancy: bronchopulmonary dysplasia (BPD), diffuse lung disease (DLD), pulmonary hypertension (PH), and sleep disordered breathing (SDB).…”

“…Survival and outcomes of infants with respiratory disease have improved significantly over the last few decades, particularly in the case of premature babies 1 . This progress is attributable to evidence‐based improvements in prenatal care and neonatal intensive care unit practices, surfactant replacement, as well as targeted diagnostics and therapeutics including access to precision genetic testing, and specialized multidisciplinary care 2,3 . In this review, we highlight common respiratory disorders that affect infants and require the involvement of pediatric pulmonologists and sleep specialists.…”