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Therapeutic interventions and short-term outcomes for infants with severe bronchopulmonary dysplasia born at <32 weeks’ gestation

Journal of Perinatology volume 33, pages 877–881 (2013)Cite this article

Subjects

Abstract

Objective:

To characterize the treatments and short-term outcomes in infants with severe bronchopulmonary dysplasia (sBPD) referred to regional neonatal intensive care units.

Study Design:

Infants born <32 weeks’ gestation with sBPD were identified using the Children’s Hospital Neonatal Database. Descriptive outcomes are reported.

Result:

A total of 867 patients were eligible. On average, infants were born at 26 weeks’ gestation and referred 43 days after birth. Infants frequently experienced lung injury (pneumonia: 24.1%; air leak: 9%) and received systemic corticosteroids (61%) and mechanical ventilation (median duration 37 days). Although 91% survived to discharge, the mean post-menstrual age was 47 weeks. Ongoing care such as supplemental oxygen (66%) and tracheostomy (5%) were frequently needed.

Conclusion:

Referred infants with sBPD sustain multiple insults to lung function and development. Because affected infants have no proven, safe or efficacious therapy and endure an exceptional burden of care even after referral, urgent work is required to observe and improve their outcomes.

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Acknowledgements

Jeanette Asselin, David Durand, Francine Dykes, Jacquelyn Evans (Chair), Karna Murthy, Michael Padula, Eugenia Pallotto, Kristina Reber and Billie Short are members of the Children’s Hospital Neonatal Consortium (CHNC), Inc. The CHNC has partnered with Children’s Hospital Association, Inc (Overland Park, KS) in order to design, launch and maintain the CHND. We are indebted to the following institutions that serve infants and their families, and these institutions also have invested in and continue to participate in the CHND. The site sponsors for the CHND are also included: Children’s Healthcare of Atlanta, Atlanta, GA (Francine Dykes, Anthony Piazza); Children’s Healthcare of Atlanta at Scottish Rite (Gregory Sysyn); Children’s Hospital of Alabama, Birmingham, AL (Carl Coghill); Le Bonheur Children’s Hospital, Memphis, TN (Ramasubbareddy Dhanireddy); Children’s Hospital Boston, Boston, MA (Anne Hansen); Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL (Karna Murthy); Nationwide Children’s Hospital, Columbus, OH (Kristina Reber); Children’s Medical Center, Dallas, TX (Rashmin Savani, Luc Brion); Children’s Hospital Colorado, Aurora, CO (Theresa Grover); Children’s Hospital of Michigan, Detroit, MI (Girija Natarajan); Cook Children’s Health Care System, Fort Worth, TX (Jonathan Nedrelow, Annie Chi); Texas Children’s Hospital, Houston, TX (Yvette Johnson); Children’s Mercy Hospitals and Clinics, Kansas City, MO (Eugenia Pallotto); Arkansas Children’s Hospital, Little Rock, AR (Becky Rodgers); Children’s Hospital Los Angeles, Los Angeles, CA (Lisa Kelly (deceased), Steven Chin); Children’s Hospital and Research Center Oakland, Oakland, CA (David Durand, Jeanette Asselin); The Children’s Hospital of Philadelphia, Philadelphia, PA (Jacquelyn Evans, Michael Padula); Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (Beverly Brozanski); St Louis Children’s Hospital, St Louis, MO (Joan Rosenbaum, Tasmin Najaf, Amith Mathur, Rakesh Rao); All Children’s Hospital, St Petersburg, FL (Victor McKay); Rady Children’s Hospital, San Diego, CA (Mark Speziale); Children’s National Medical Center, Washington, DC (Billie Short); AI DuPont Hospital for Children, Wilmington, DE (Kevin Sullivan); Primary Children’s Medical Center, Salt Lake City, UT (Donald Null); Children’s Hospital of Wisconsin, Milwaukee, WI (Michael Uhing)#; Children’s Hospital of Omaha (Lynne Willett John Grebe)#; Florida Hospital for Children (Rajan Wadhawan)#. #Institution and site sponsor began participation during 2011-2012 academic year.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M A Padula & J R Evans

  2. Department of Pediatrics, Colorado Children's Hospital, University of Colorado School of Medicine, Aurora, CO, USA

    T R Grover

  3. Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA

    B Brozanski

  4. Children’s Hospital Association, Overland Park, KS, USA

    I Zaniletti

  5. Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, Center for Perinatal Research, Columbus, OH, USA

    L D Nelin & K M Reber

  6. Department of Pediatrics, Division of Neonatal Medicine, Children’s Hospital Oakland and Research Center, Oakland, CA, USA

    J M Asselin & D J Durand

  7. Department of Pediatrics, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA

    B L Short

  8. Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri School of Medicine, Kansas, MO, USA

    E K Pallotto

  9. Department of Pediatrics, Children's Healthcare of Atlanta at Egleston, Emory University School of Medicine, Atlanta, GA, USA

    F D Dykes

  10. Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    K Murthy

Authors
  1. M A Padula
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  2. T R Grover
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  3. B Brozanski
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  5. L D Nelin
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  6. J M Asselin
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  8. B L Short
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  11. K M Reber
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Corresponding author

Correspondence to K Murthy.

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Competing interests

A portion of Ms Asselin’s salary was provided by Children’s Hospital Association, Inc., for the development and maintenance of the database that was analyzed for this study. The remaining authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Padula, M., Grover, T., Brozanski, B. et al. Therapeutic interventions and short-term outcomes for infants with severe bronchopulmonary dysplasia born at <32 weeks’ gestation. J Perinatol 33, 877–881 (2013). https://doi.org/10.1038/jp.2013.75

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  • DOI: https://doi.org/10.1038/jp.2013.75

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