A multidisciplinary chronic lung disease team in a neonatal intensive care unit is associated with increased survival to discharge of infants with tracheostomy.

Autor: Hansen TP; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA., Noel-MacDonnell J; Health Services and Outcome Research, Children's Mercy Kansas City, Kansas City, MO, USA.; School of Medicine, University of Missouri-Kanas City, Kansas City, MO, USA., Kuckelman S; School of Medicine, University of Kansas, Lawrence, KS, USA., Norberg M; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA., Truog W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA.; School of Medicine, University of Missouri-Kanas City, Kansas City, MO, USA., Manimtim W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, MO, USA. wmmanimtim@cmh.edu.; School of Medicine, University of Missouri-Kanas City, Kansas City, MO, USA. wmmanimtim@cmh.edu.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2021 Aug; Vol. 41 (8), pp. 1963-1971. Date of Electronic Publication: 2021 Apr 01.
DOI: 10.1038/s41372-021-00974-2
Abstrakt: Objective: To determine if multidisciplinary team-based care of severe BPD/CLD infants improve survival to discharge.
Design/methods: Retrospective review of severe BPD/CLD infants cared for by dedicated multidisciplinary CLD team using consensus-driven protocols and guidelines.
Results: Total of 267 patients. Median gestational age was 26 weeks (IQR 24, 32); median birth-weight was 0.85 (IQR 0.64, 1.5). Twenty-four percent were preterm with severe BPD, 46% had other primary respiratory diseases (none BPD diseases). Total number of patients, proportion of patients with tracheostomy, prematurity, and genetic diagnoses increased over time. 88.8% survived to discharge. Unadjusted logistic regression showed that tracheostomy was not associated with odds of death; secondary pulmonary hypertension was associated with odds of tracheostomy (OR = 1.795 p value = 0.0264), or death (OR = 8.587 p value = <0.0001), or tracheostomy + death (OR = 13.58 p value = 0.0007).
Conclusions: Over time, mortality improved for infants with tracheostomy cared for by a multidisciplinary severe BPD/CLD team. Secondary pulmonary hypertension was associated with tracheostomy, or death, or tracheostomy + death.
(© 2021. The Author(s), under exclusive licence to Springer Nature America, Inc. part of Springer Nature.)
Databáze: MEDLINE
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