Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home

A. Ioana Cristea, Aaron Carroll, Stephanie Davis, Nancy Swigonski, Veda L. Ackerman

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

OBJECTIVE: To describe the incidence and outcomes of children with chronic respiratory failure secondary to severe bronchopulmonary dysplasia (BPD) on chronic positive pressure ventilation (PPV) via tracheostomy at home. METHODS: We retrospectively reviewed medical charts of patients with severe BPD who were PPV dependent at home and who were enrolled in a university-affiliated home ventilator program between 1984 and 2010. We excluded patients with other comorbidities that could contribute to the development of chronic respiratory failure. We reported the incidence of these children in Indiana and cumulative incidences of survival, liberation from PPV, and decannulation. RESULTS: Over 27 years, 628 children were cared for in our home ventilator program. Of these, 102 patients met inclusion criteria: 83 (81.4%) were alive and 19 (18.6%) were deceased. Sixty-nine patients (67.6%) were liberated from PPV, and 97.1% of them were weaned before their fifth birthday, with a median age at liberation of 24 months (interquartile range, 19-33). Similarly, 60 patients (58.8%) were decannulated, of which 96.7% completed this process before their sixth birthday, with a median age at decannulation of 37.5 months (interquartile range, 31.5-45). The incidence of children with chronic respiratory failure secondary to BPD who were PPVdependent at home in Indiana was 1.23 per 100 000 live births in 1984 and increased to 4.77 per 100 000 live births in 2010. CONCLUSIONS: Although extreme prematurity associated with severe BPD necessitating PPV at home carries significant risks of morbidity and mortality, successful liberation from mechanical ventilation and decannulation are likely to occur.

Original languageEnglish
JournalPediatrics
Volume132
Issue number3
DOIs
StatePublished - Sep 2013

Fingerprint

Bronchopulmonary Dysplasia
Positive-Pressure Respiration
Mechanical Ventilators
Respiratory Insufficiency
Incidence
Live Birth
Tracheostomy
Artificial Respiration
Comorbidity
Morbidity
Survival
Mortality
Liberation

Keywords

  • Bronchopulmonary dysplasia
  • Home
  • Outcome
  • Positive pressure ventilation
  • Tracheostomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home. / Ioana Cristea, A.; Carroll, Aaron; Davis, Stephanie; Swigonski, Nancy; Ackerman, Veda L.

In: Pediatrics, Vol. 132, No. 3, 09.2013.

Research output: Contribution to journalArticle

@article{5b3a25dbafe24b9289c6d6dc736a7e40,
title = "Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home",
abstract = "OBJECTIVE: To describe the incidence and outcomes of children with chronic respiratory failure secondary to severe bronchopulmonary dysplasia (BPD) on chronic positive pressure ventilation (PPV) via tracheostomy at home. METHODS: We retrospectively reviewed medical charts of patients with severe BPD who were PPV dependent at home and who were enrolled in a university-affiliated home ventilator program between 1984 and 2010. We excluded patients with other comorbidities that could contribute to the development of chronic respiratory failure. We reported the incidence of these children in Indiana and cumulative incidences of survival, liberation from PPV, and decannulation. RESULTS: Over 27 years, 628 children were cared for in our home ventilator program. Of these, 102 patients met inclusion criteria: 83 (81.4{\%}) were alive and 19 (18.6{\%}) were deceased. Sixty-nine patients (67.6{\%}) were liberated from PPV, and 97.1{\%} of them were weaned before their fifth birthday, with a median age at liberation of 24 months (interquartile range, 19-33). Similarly, 60 patients (58.8{\%}) were decannulated, of which 96.7{\%} completed this process before their sixth birthday, with a median age at decannulation of 37.5 months (interquartile range, 31.5-45). The incidence of children with chronic respiratory failure secondary to BPD who were PPVdependent at home in Indiana was 1.23 per 100 000 live births in 1984 and increased to 4.77 per 100 000 live births in 2010. CONCLUSIONS: Although extreme prematurity associated with severe BPD necessitating PPV at home carries significant risks of morbidity and mortality, successful liberation from mechanical ventilation and decannulation are likely to occur.",
keywords = "Bronchopulmonary dysplasia, Home, Outcome, Positive pressure ventilation, Tracheostomy",
author = "{Ioana Cristea}, A. and Aaron Carroll and Stephanie Davis and Nancy Swigonski and Ackerman, {Veda L.}",
year = "2013",
month = "9",
doi = "10.1542/peds.2012-2990",
language = "English",
volume = "132",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "3",

}

TY - JOUR

T1 - Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home

AU - Ioana Cristea, A.

AU - Carroll, Aaron

AU - Davis, Stephanie

AU - Swigonski, Nancy

AU - Ackerman, Veda L.

PY - 2013/9

Y1 - 2013/9

N2 - OBJECTIVE: To describe the incidence and outcomes of children with chronic respiratory failure secondary to severe bronchopulmonary dysplasia (BPD) on chronic positive pressure ventilation (PPV) via tracheostomy at home. METHODS: We retrospectively reviewed medical charts of patients with severe BPD who were PPV dependent at home and who were enrolled in a university-affiliated home ventilator program between 1984 and 2010. We excluded patients with other comorbidities that could contribute to the development of chronic respiratory failure. We reported the incidence of these children in Indiana and cumulative incidences of survival, liberation from PPV, and decannulation. RESULTS: Over 27 years, 628 children were cared for in our home ventilator program. Of these, 102 patients met inclusion criteria: 83 (81.4%) were alive and 19 (18.6%) were deceased. Sixty-nine patients (67.6%) were liberated from PPV, and 97.1% of them were weaned before their fifth birthday, with a median age at liberation of 24 months (interquartile range, 19-33). Similarly, 60 patients (58.8%) were decannulated, of which 96.7% completed this process before their sixth birthday, with a median age at decannulation of 37.5 months (interquartile range, 31.5-45). The incidence of children with chronic respiratory failure secondary to BPD who were PPVdependent at home in Indiana was 1.23 per 100 000 live births in 1984 and increased to 4.77 per 100 000 live births in 2010. CONCLUSIONS: Although extreme prematurity associated with severe BPD necessitating PPV at home carries significant risks of morbidity and mortality, successful liberation from mechanical ventilation and decannulation are likely to occur.

AB - OBJECTIVE: To describe the incidence and outcomes of children with chronic respiratory failure secondary to severe bronchopulmonary dysplasia (BPD) on chronic positive pressure ventilation (PPV) via tracheostomy at home. METHODS: We retrospectively reviewed medical charts of patients with severe BPD who were PPV dependent at home and who were enrolled in a university-affiliated home ventilator program between 1984 and 2010. We excluded patients with other comorbidities that could contribute to the development of chronic respiratory failure. We reported the incidence of these children in Indiana and cumulative incidences of survival, liberation from PPV, and decannulation. RESULTS: Over 27 years, 628 children were cared for in our home ventilator program. Of these, 102 patients met inclusion criteria: 83 (81.4%) were alive and 19 (18.6%) were deceased. Sixty-nine patients (67.6%) were liberated from PPV, and 97.1% of them were weaned before their fifth birthday, with a median age at liberation of 24 months (interquartile range, 19-33). Similarly, 60 patients (58.8%) were decannulated, of which 96.7% completed this process before their sixth birthday, with a median age at decannulation of 37.5 months (interquartile range, 31.5-45). The incidence of children with chronic respiratory failure secondary to BPD who were PPVdependent at home in Indiana was 1.23 per 100 000 live births in 1984 and increased to 4.77 per 100 000 live births in 2010. CONCLUSIONS: Although extreme prematurity associated with severe BPD necessitating PPV at home carries significant risks of morbidity and mortality, successful liberation from mechanical ventilation and decannulation are likely to occur.

KW - Bronchopulmonary dysplasia

KW - Home

KW - Outcome

KW - Positive pressure ventilation

KW - Tracheostomy

UR - http://www.scopus.com/inward/record.url?scp=84884559972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884559972&partnerID=8YFLogxK

U2 - 10.1542/peds.2012-2990

DO - 10.1542/peds.2012-2990

M3 - Article

C2 - 23918888

AN - SCOPUS:84884559972

VL - 132

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 3

ER -