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Respiratory management and bronchopulmonary dysplasia in extremely preterm infants: a comparison of practice between centres in Oxford and Melbourne

Journal of Perinatology volume 42, pages 53–57 (2022)Cite this article

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Abstract

Objective

Considerable variation in the care of extremely low gestational age infants (ELGAN) contributes to the variation in incidence of bronchopulmonary dysplasia (BPD). We compared management and outcomes of two neonatal centres with different respiratory support strategies.

Study design

Retrospective cohort study of infants <28 weeks gestational age treated at two units in Australia and the UK between 2015 and 2017.

Result

Of 492 infants, the overall incidence of BPD for extremely preterm infants was 62.20% and was similar across both sites (64.84% at Monash vs. 60.65% at Oxford). Independent predictors for the development of BPD or mortality included the days on mechanical ventilation (MV, adjusted OR 1.13, 95% Cl 1.07–1.19) and use of inhaled nitric oxide (adjusted OR 13.42, 95% Cl 1.75–103.28).

Conclusion

Primary choice of non-invasive respiratory support had no significant impact on BPD development. Duration of MV and using nitric oxide were independent predictors for death or BPD.

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Fig. 1: Study population.
Fig. 2: Time (in days) off all respiratory support.
Fig. 3: Time (in days) to come off all respiratory support amongst infants with BPD.

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Acknowledgements

We would like to thank Prof. Neena Modi and Dr. Chris Gale (Imperial College London) for their tireless work in leading and managing the NNRD.

Author information

Author notes

  1. Sunjuri Sun

    Present address: Nuffield Department of Population Health, National Perinatal Epidemiology Unit, Medical Sciences Division, University of Oxford, Oxford, UK

  2. These authors contributed equally: C.C. Roehr, K. Tan.

Authors and Affiliations

  1. Department of Paediatrics, School of Clinical Sciences (SCS) at Monash Health, Monash University, Melbourne, VIC, Australia

    Sunjuri Sun & Kenneth Tan

  2. Department of Paediatrics, Medical Sciences Division, University of Oxford, Oxford, UK

    Sanja Zivanovic

  3. Newborn Services, John Radcliffe Hospital, Oxford University Hospitals, Oxford, UK

    Sanja Zivanovic & Charles Christoph Roehr

  4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Arul Earnest

  5. Nuffield Department of Population Health, National Perinatal Epidemiology Unit, Medical Sciences Division, University of Oxford, Oxford, UK

    Charles Christoph Roehr

  6. Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia

    Kenneth Tan

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  1. Sunjuri Sun
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  4. Charles Christoph Roehr
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Contributions

KT and CCR conceived the study. SS and SZ collected the data. SS, KT and AE analysed the data and all authors contributed to interpretation of the data. SS wrote the first draft of the manuscript and all authors (SS, SZ, AE, KT and CCR) contributed to drafting or revising the manuscript critically for important intellectual content.

Corresponding author

Correspondence to Charles Christoph Roehr.

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The authors declare no competing interests.

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Sun, S., Zivanovic, S., Earnest, A. et al. Respiratory management and bronchopulmonary dysplasia in extremely preterm infants: a comparison of practice between centres in Oxford and Melbourne. J Perinatol 42, 53–57 (2022). https://doi.org/10.1038/s41372-021-01274-5

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