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.