Outcomes of Ventilator-Dependent Children With Severe Bronchopulmonary Dysplasia and Tracheobronchomalacia.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-04-01 DOI:10.1002/ppul.71100

Manvi Bansal, Winston M Manimtim, Amit Agarwal, Stamatia Alexiou, Jessica L Rice, Leif Nelin, Audrey N Miller, Jonathan C Levin, Khanh Lai, Jacob A Kaslow, Lystra P Hayden, Julie L Fierro, Anita Bhandari, Eric D Austin, Brianna Aoyama, Gangaram Akangire, Natalie Villafranco, Nicole Stephenson, Roopa Siddaiah, Robin L McKinney, Melissa A House, Christopher D Baker, Steven H Abman, Sharon A McGrath-Morrow, Joseph M Collaco

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引用次数: 0

Abstract

Objectives: To characterize an observational cohort of ventilator-dependent infants and children with bronchopulmonary dysplasia (BPD) with or without tracheobronchomalacia (TBM) and determine the impact of TBM on the need for ventilator support, liberation from the ventilator and tracheostomy decannulation.

Methods: Demographics and clinical outcomes were obtained by retrospective review from 12 centers participating in the outpatient BPD Collaborative registry. The cohort consisted of infants born between 2016 and 2021 who were dependent on invasive mechanical ventilation at home. The respiratory outcomes of those infants with TBM were compared to those who did not have TBM.

Results: There were 154 subjects included and about half (48.7%) had documented TBM. Both the TBM and non-TBM groups had similar demographic characteristics and respiratory outcomes. However, the non-TBM were found to have lower mean birth weight (673 vs. 832 grams; p = 0.006), higher likelihood of having Nissen fundoplication (34.2% vs. 12.2%; p = 0.006) and higher use of diuretics (59.2% vs. 37.3%; p = 0.007). Both groups were similar in terms of ventilator requirements, timing of liberation from the ventilator, and rate of decannulation.

Conclusions: The presence of TBM in ventilator-dependent infants with BPD did not affect ventilator support needs, liberation from the ventilator and the rate of tracheostomy decannulation. We speculate that the relative contributions of the other components of BPD disease may play critical roles in determining the need for tracheostomy and their ultimate respiratory outcomes. A prospective multicenter study to assess the impact of TBM in severe BPD is urgently needed.

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严重支气管肺发育不良和气管支气管软化症依赖呼吸机儿童的预后。

目的：对支气管肺发育不良（BPD）伴或不伴气管支气管弛缓症（TBM）的依赖呼吸机的婴儿和儿童进行观察性队列研究，并确定TBM对呼吸机支持需求、脱离呼吸机和气管切开术脱管的影响。方法：回顾性分析参与门诊BPD协作登记的12个中心的人口统计学和临床结果。该队列包括2016年至2021年间出生的婴儿，他们依赖于家中有创机械通气。将患有TBM的婴儿与没有TBM的婴儿的呼吸结果进行比较。结果：共纳入154名受试者，约一半（48.7%）有TBM。TBM组和非TBM组具有相似的人口统计学特征和呼吸结果。然而，非tbm组的平均出生体重较低(673克对832克；p = 0.006)，尼森底重复的可能性更高(34.2% vs. 12.2%；P = 0.006)和较高的利尿剂使用率(59.2% vs. 37.3%；p = 0.007)。两组在呼吸机需求、脱离呼吸机时间和脱管率方面相似。结论：依赖呼吸机的BPD患儿存在TBM不影响呼吸机支持需求、脱离呼吸机和气管切开取管率。我们推测BPD疾病的其他组成部分的相对贡献可能在决定气管切开术的需要及其最终呼吸结果方面发挥关键作用。迫切需要一项前瞻性的多中心研究来评估TBM对重度BPD的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.