Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 32, Issue 10, Pages 960-967Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0035-1547326
Keywords
chronic lung disease of prematurity; multicenter collaborative; snapshot; bronchopulmonary dysplasia
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Funding
- NCATS NIH HHS [UL1 TR001082] Funding Source: Medline
- NHLBI NIH HHS [K23 HL121090] Funding Source: Medline
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Objectives Despite improvements in survival of preterm infants, bronchopulmonary dysplasia (BPD) remains a persistent morbidity. The incidence, clinical course, and current management of severe BPD (sBPD) remain to be defined. To address these knowledge gaps, a multicenter collaborative was formed to improve outcomes in this population. Study Design We performed a snapshot in eight neonatal intensive care units (NICUs) on December 17, 2013. A standardized clinical data form for each inpatient born at < 32 weeks was completed and collated centrally for analysis. sBPD was defined as receiving >= 30% supplemental oxygen and/or receiving positive pressure ventilation at 36 weeks postmenstrual age (PMA). Results Of a total census of 710 inpatients, 351 infants were born at < 32 weeks and 128 of those (36.5%) met criteria for sBPD. The point prevalence of sBPD varied between centers (11-58%; p < 0.001). Among infants with sBPD there was a variation among centers in the use of mechanical ventilation at 28 days of life (p < 0.001) and at 36 weeks PMA (p = 0.001). We observed differences in the use of diuretics (p = 0.018), inhaled corticosteroids (p < 0.001), and inhaled beta-agonists (p < 0.001). Conclusion The high point prevalence of sBPD and variable management among NICUs emphasizes the lack of evidence in guiding optimal care to improve long-term outcomes of this high-risk, understudied population.
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