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Hyperinflation and its association with successful transition to home ventilator devices in infants with chronic respiratory failure and severe bronchopulmonary dysplasia

Journal of Perinatology volume 43, pages 332–336 (2023)Cite this article

Subjects

Abstract

Objective

To estimate the association between lung hyperinflation and the time to successful transition to home ventilators in infants with sBPD and chronic respiratory failure.

Design/methods

Infants with sBPD <32 weeks’ gestation who received tracheostomies were identified. Hyperinflation was the main exposure. Time from tracheostomy to successful transition to the home ventilator was the main outcome. Kaplan-Meier and multivariable Cox proportional hazards were used to estimate the relationships between hyperinflation and the main outcome.

Results

Sixty-two infants were included; 26 (42%) were hyperinflated. Eleven died before transition, and 51 successfully transitioned. Hyperinflation was associated with both mortality (31% vs 8.3%, p = 0.02) and an increased duration (72 vs. 56 days) to successful transition (hazard ratio (HR) = 0.38, 95% CI: 0.19, 0.76, p = 0.006). Growth velocity was similar after tracheostomy placement.

Conclusions

In infants with chronic respiratory failure and sBPD <32 weeks’ gestation, hyperinflation is related to mortality and inpatient morbidities.

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Fig. 1: Exclusion diagram for selection of patients used in the analysis.
Fig. 2: Kaplan Meier analysis of timing to successful transition to home ventilators stratified by hyperinflation.

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Data availability

All data generated or analyzed during this study are included in this published article.

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Author information

Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University & The Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Megan Lagoski, Michael Reisfeld, Ryan J. Carpenter, Emilee Lamorena, Denise M. Goodman & Karna Murthy

  2. The Children’s Hospitals Neonatal Consortium, Dover, DE, USA

    Karna Murthy

Authors
  1. Megan Lagoski
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  2. Michael Reisfeld
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  3. Ryan J. Carpenter
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  4. Emilee Lamorena
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  5. Denise M. Goodman
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  6. Karna Murthy
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Contributions

ML is the first and corresponding author of this paper and is responsible for the initial study concept, writing and editing the original manuscript, and data abstracting. MR contributed to the article by data abstraction and contributing to the methods and results section. RJC assisted in the RedCAP database design and edited the manuscript. EL assisted in research design and information regarding home ventilators. DG assisted in the study design and in editing the manuscript. KM assisted in study design and analyzed the data. He also edited the manuscript.

Corresponding author

Correspondence to Megan Lagoski.

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Competing interests

The authors have no relevant financial relationships or conflicts of interests to disclose related to the (1) study design; (2) collection, analysis, and interpretation of data; (3) writing of the report; and (4) decision to submit the paper for publication. KM is a Board member of Children’s Hospitals Neonatal Consortium, a 501c3 organization that developed and maintained a database that was used to identify database records of infants for this project. This study was approved by the Ann and Robert H. Lurie Children’s Hospital Institutional Review Board (IRB 2020-3773) and data obtained from Children’s Hospital Neonatal Database (IRB 2009-13982).

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Lagoski, M., Reisfeld, M., Carpenter, R.J. et al. Hyperinflation and its association with successful transition to home ventilator devices in infants with chronic respiratory failure and severe bronchopulmonary dysplasia. J Perinatol 43, 332–336 (2023). https://doi.org/10.1038/s41372-022-01575-3

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