Characteristics associated with death or tracheostomy in infants with bronchopulmonary dysplasia following predominant non-invasive respiratory support

Objective: Identify characteristics associated with death or tracheostomy (D/T) in preterm infants with bronchopulmonary dysplasia (BPD) predominantly managed with non-invasive respiratory support prior to 36 weeks postmenstrual age (PMA). Study design: Retrospective cohort study at Children's Hospital of Philadelphia of 134 infants meeting inclusion criteria between 2010 and 2017. Various clinical characteristics were considered as predictor variables of the primary outcome, D/T; those associated at p < 0.10 in bivariable logistic regression were evaluated in multivariable models. Results: Twenty-one (16%) infants had D/T. Treatment with pulmonary vasodilators and the presence of pulmonary hypertension (PH) on echocardiogram at 36 weeks PMA were associated with D/T in bivariable analyses. Pulmonary vasodilator use remained statistically significant in adjusted multivariable models. Conclusions: We identified a strong association between PH and D/T in this cohort. Our findings emphasize the importance of specialized BPD management that includes early identification of PH in this high-risk population.