Susan McAnany, Gangaram Akangire, Ashley Sherman, Venkatesh Sampath, Winston Manimtim
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引用次数: 0
Abstract
This study aimed to compare the accuracy of three newly proposed definitions of bronchopulmonary dysplasia (BPD) in predicting outcomes, and to investigate the impact of large airway versus parenchymal versus vascular BPD phenotypes on BPD outcomes.Retrospective chart review of 100 infants with severe BPD discharged from a Children's hospital between 2020 and 2021. Multivariable models evaluated the associations between BPD definitions and phenotypes with tracheostomy and death at 6 months and 1 year after NICU discharge. Secondary outcomes included the need for respiratory support, the use of pulmonary medications, and the need for long-term gastrostomy feeding.Neonatal research network (NRN) and BPD collaborative criteria best-predicted outcomes associated with tracheostomy and/or death (p < 0.001). Among the three BPD phenotypes, large airway disease was independently associated with death or tracheostomy (odds ratios [OR]: 10.5; 95% confidence interval [CI]: 1.6, 68.1). The combination of all three phenotypes was also associated with death or tracheostomy (OR: 9.8; 95% CI: 1.0, 93.5). Both NRN and BPD collaborative definitions showed an association with the need for respiratory support, medication use, and need for long-term gastrostomy tube feeding. Among the 29 infants for whom complete information was available, 18 (62%), 20 (69%), and 18 (62%) had parenchymal, central airway and pulmonary vascular phenotype, respectively.Our results indicate that newer definitions of BPD may better predict the severity of BPD and the need for long-term invasive ventilation support compared with the 2001 National Institute of Health definition of BPD phenotypes impacting mortality and short-term outcomes. These data may be useful for counseling families and developing phenotype-based individualized treatment plans. · The current definition of BPD has limitations.. · New definitions of BPD better predict outcomes.. · BPD phenotypes can better predict outcomes..
期刊介绍:
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.