Therapeutic interventions and short-term outcomes for infants with severe bronchopulmonary dysplasia born at <32 weeks’ gestation

Abstract

OBJECTIVE: To characterize the treatments and short-term outcomes in infants with severe bronchopulmonary dysplasia (sBPD) referred to regional neonatal intensive care units. STUDY DESIGN: Infants born o32 weeks' gestation with sBPD were identified using the Children's Hospital Neonatal Database. Descriptive outcomes are reported. RESULT: A total of 867 patients were eligible. On average, infants were born at 26 weeks' gestation and referred 43 days after birth. Infants frequently experienced lung injury (pneumonia: 24.1%; air leak: 9%) and received systemic corticosteroids (61%) and mechanical ventilation (median duration 37 days). Although 91% survived to discharge, the mean post-menstrual age was 47 weeks. Ongoing care such as supplemental oxygen (66%) and tracheostomy (5%) were frequently needed. CONCLUSION: Referred infants with sBPD sustain multiple insults to lung function and development. Because affected infants have no proven, safe or efficacious therapy and endure an exceptional burden of care even after referral, urgent work is required to observe and improve their outcomes.

The influence of small for gestational age status on outpatient bronchopulmonary dysplasia outcomes

“…Conversely, some of the infants with the most severe cases of BPD may not have survived to discharge, and thus to referral. A recent descriptive study by Padula et al 20 detailing short-term outcomes for a large, multicenter cohort of infants with severe BPD born at <32 weeks gestation quoted a 9% mortality rate in infants with severe BPD before discharge. Additionally, travel distance to our institution may have been prohibitive for some families whose infants had been referred.…”

Interdisciplinary Care of Children with Severe Bronchopulmonary Dysplasia

“…6,7 The Children’s Hospital Neonatal Consortium reported a 16% incidence of sBPD of patients born at <32 weeks, of whom 91% survived to discharge, 66% were discharged on supplemental oxygen, 4% on mechanical ventilation, and 5% received tracheostomy. 8 The BPD Collaborative reported a point prevalence of sBPD of 36.5% with a range across centers of 11%–58%, and 41% of the patients with sBPD had type 2 sBPD with a range of 0%–68%. 9 Using an estimated incidence of sBPD of 16% for infants born at <32 weeks suggests that ~13 000 patients develop sBPD annually in the US alone.…”

Determinants of Severe Metabolic Bone Disease in Very Low-Birth-Weight Infants with Severe Bronchopulmonary Dysplasia Admitted to a Tertiary Referral Center

“…Moreover, infants with severe BPD transferred to tertiary neonatal centers represent a unique cohort due to the acuity of their lung disease and high frequency of nonrespiratory comorbidities. 17,18 The characteristics of MBD in this high-risk population are not well established. The objectives of the present study were to describe the incidence, severity, and risk factors for MBD in a contemporary, tertiary referral-based cohort of infants with severe BPD.…”