Factors associated with liberation from home mechanical ventilation and tracheostomy decannulation in infants and children with severe bronchopulmonary dysplasia

被引：1

作者：

Agarwal, Amit ^{[1
,2
]}

Manimtim, Winston M. ^{[3
,4
]}

Alexiou, Stamatia ^{[5
,6
]}

Abman, Steven H. ^{[7
]}

Akangire, Gangaram ^{[3
,4
]}

Aoyama, Brianna C. ^{[8
]}

Austin, Eric D. ^{[9
,10
]}

Baker, Christopher D. ^{[7
]}

Bansal, Manvi ^{[11
]}

Bauer, Sarah E. ^{[12
,13
]}

Cristea, A. Ioana ^{[12
,13
]}

Dawson, Sara K. ^{[14
]}

Fierro, Julie L. ^{[5
,6
]}

Hayden, Lystra P. ^{[15
,16
]}

Henningfeld, Jennifer K. ^{[14
]}

Kaslow, Jacob A. ^{[9
,10
]}

Lai, Khanh V. ^{[17
]}

Levin, Jonathan C. ^{[15
,16
,18
]}

McKinney, Robin L. ^{[19
]}

Miller, Audrey N. ^{[20
,21
]}

Nelin, Leif D. ^{[20
,21
]}

Popova, Antonia P. ^{[22
]}

Siddaiah, Roopa ^{[23
]}

Tracy, Michael C. ^{[24
]}

Villafranco, Natalie M. ^{[25
,26
]}

McGrath-Morrow, Sharon A. ^{[5
,6
]}

Collaco, Joseph M. ^{[8
]}

机构：

[1] Arkansas Childrens Hosp, Div Pulm Med, Little Rock, AR 72202 USA

[2] Univ Arkansas Med Sci, Little Rock, AR 72205 USA

[3] Childrens Mercy Kansas City, Div Neonatol, Kansas City, MO USA

[4] Univ Missouri, Kansas City Sch Med, Kansas City, MO USA

[5] Childrens Hosp Philadelphia, Div Pulm Med, Philadelphia, PA USA

[6] Univ Penn, Philadelphia, PA USA

[7] Univ Colorado, Sch Med, Dept Pediat, Sect Pulm & Sleep Med, Aurora, CO USA

[8] Johns Hopkins Univ, Eudowood Div Pediat Resp Sci, Baltimore, MD USA

[9] Vanderbilt Univ, Pulm Med, Nashville, TN USA

[10] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[11] Childrens Hosp Los Angeles, Pulmonol & Sleep Med, Los Angeles, CA USA

[12] Riley Childrens Hosp, Div Pediat Pulmonol Allergy & Sleep Med, Indianapolis, IN USA

[13] Indiana Univ, Indianapolis, IN USA

[14] Med Coll Wisconsin Milwaukee, Dept Pediat, Milwaukee, WI USA

[15] Boston Childrens Hosp, Div Pulm Med, Boston, MA USA

[16] Harvard Med Sch, Boston, MA USA

[17] Univ Utah, Div Pediat Pulm & Sleep Med, Salt Lake City, UT USA

[18] Boston Childrens Hosp, Div Newborn Med, Boston, MA USA

[19] Brown Univ, Sch Med, Dept Pediat, Providence, RI USA

[20] Nationwide Childrens Hosp, Div Neonatol, Columbus, OH USA

[21] Ohio State Univ, Columbus, OH USA

[22] Univ Michigan, Pediat Pulmonol, Ann Arbor, MI USA

[23] Penn State Hlth, Pediat Pulmonol, Hershey, PA USA

[24] Stanford Univ, Div Pediat Pulm Asthma & Sleep Med, Stanford, CA USA

[25] Texas Childrens Hosp, Pulm Med, Houston, TX USA

[26] Baylor Coll Med, Houston, TX USA

来源：

JOURNAL OF PERINATOLOGY | 2024年

基金：

美国国家卫生研究院;

关键词：

PRETERM INFANTS; CARE; PLACEMENT;

D O I：

10.1038/s41372-024-02078-z

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

ObjectiveTo identify factors associated with the timing of ventilator liberation and tracheostomy decannulation among infants with severe bronchopulmonary dysplasia (sBPD) who required chronic outpatient invasive ventilation.Study designMulticenter retrospective study of 154 infants with sBPD on outpatient ventilators. Factors associated with ventilator liberation and decannulation were identified using Cox regression models and multilevel survival models.ResultsVentilation liberation and decannulation occurred at median ages of 27 and 49 months, respectively. Older age at transition to a portable ventilator and at discharge, higher positive end expiratory pressure, and multiple respiratory readmissions were associated with delayed ventilator liberation. Surgical management of gastroesophageal reflux was associated with later decannulation.ConclusionsVentilator liberation timing was impacted by longer initial admissions and higher ventilator pressure support needs, whereas decannulation timing was associated with more aggressive reflux management. Variation in the timing of events was primarily due to individual-level factors, rather than center-level factors.

引用

页数：7

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