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Am J Perinatol 2015; 32(10): 960-967
DOI: 10.1055/s-0035-1547326
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Point Prevalence, Clinical Characteristics, and Treatment Variation for Infants with Severe Bronchopulmonary Dysplasia

Milenka Cuevas Guaman   *
1   Division of Neonatology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
,
Jason Gien   *
2   Division of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
,
Christopher D. Baker   *
3   Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
,
Huayan Zhang   *
4   Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
,
Eric D. Austin
5   Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Vanderbilt, Tennessee
,
Joseph M. Collaco   *
6   Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

18 November 2014

05 January 2015

Publication Date:
04 March 2015 (online)

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Abstract

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 β-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.

Keywords

chronic lung disease of prematurity - multicenter collaborative - snapshot - bronchopulmonary dysplasia

* All authors are member of Bronchopulmonary Dysplasia Collaborative.


 

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