The effect of prolonged tracheal intubation on the association between patent ductus arteriosus and bronchopulmonary dysplasia (grades 2 and 3)

Objective To determine if the need for mechanical ventilation alters the association between prolonged patent ductus arteriosus (PDA) exposure and bronchopulmonary dysplasia (grades 2 and 3) (BPD). Study Design Observational study of 407 infants (<28 weeks' gestation) with echocardiograms performed at planned intervals. Results Twelve percent (48/407) of study infants had BPD (grades 2 and 3). In a multivariable regression model, exposure to a moderate-to-large PDA shunt for >= 7 days was associated with an increased risk of BPD (grades 2 and 3) (from 16 to 35%: aRD = 19% (6, 32%),p < 0.005) when infants required >= 10 days of intubation (n = 170). In contrast, there was no significant association between prolonged PDA exposure and BPD when infants required <= 9 days of intubation (aRD = 4%) (-1, 10%) (n = 237). Conclusions Moderate-to-large PDAs are associated with an increased risk of BPD-but only when infants require intubation >= 10 days.