Outcomes of infants with severe bronchopulmonary dysplasia who received tracheostomy and home ventilation.

Autor: Akangire G; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA., Lachica C; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA., Noel-MacDonnell J; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA.; Department of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, Missouri, USA., Begley A; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA., Sampath V; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA., Truog W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA., Manimtim W; Division of Neonatology, Children's Mercy Kansas City, Kansas City, Missouri, USA.; Department of Pediatrics, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2023 Mar; Vol. 58 (3), pp. 753-762. Date of Electronic Publication: 2022 Nov 22.
DOI: 10.1002/ppul.26248
Abstrakt: Objective: To describe the survival rate, timing of liberation from the ventilator, and factors favorable for decannulation among infants with severe bronchopulmonary dysplasia (sBPD) who received tracheostomy.
Methods: Demographics and clinical outcomes were obtained through retrospective chart review of 98 infants with sBPD who were born between 2004 and 2017, received tracheostomy at <1 year of age, and were followed in the Infant Tracheostomy and Home Ventilator clinic up to 4 years of age.
Results: The number of infants with sBPD who received tracheostomy increased significantly over the study period. The median age at tracheostomy was 4 months (IQR 3, 5) or 43 weeks corrected gestational age; the median age at NICU discharge was 7 months (IQR 6, 9). At 48 months of age, all subjects had been liberated from the ventilator, at a median age of 24 months (IQR 18, 29); 52% had been decannulated with a median age at decannulation of 32 months (IQR 26, 39). Only 1 (1%) infant died. Multivariate logistic regression showed infants who were White, liberated from the ventilator by 24 months of age and have public insurance had significantly greater odds of being decannulated by 48 months of age. Tracheobronchomalacia was associated with decreased odds of decannulation.
Conclusion: Infants with sBPD who received tracheostomy had an excellent survival rate. Liberation from home ventilation and decannulation are likely to occur by 4 years of age.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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