Am J Perinatol 2018; 35(14): 1376-1387
DOI: 10.1055/s-0038-1655761
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Clinical Outcomes among Diagnostic Subgroups of Infants with Severe Bronchopulmonary Dysplasia through 2 Years of Age

Gangaram Akangire
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Winston Manimtim
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Michael F. Nyp
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Janelle Noel-MacDonnell
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Allyssa N. Kays
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
William E. Truog
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Jane B. Taylor
1  Center for Infant Pulmonary Disorders, Children's Mercy Kansas City, Kansas City, Missouri
2  Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
› Author Affiliations
Funding None.
Further Information

Publication History

05 November 2017

18 April 2018

Publication Date:
31 May 2018 (online)

Abstract

Objective This article aimed to identify readmission risk factors through 2 years of life for infants with severe bronchopulmonary dysplasia (BPD) who do not require tracheostomy and ventilatory support after neonatal intensive care unit (NICU) discharge. It also aimed to identify if clinical differences exist between the subcategories of severe BPD.

Study Design A retrospective chart review was performed on 182 infants with severe BPD born between 2010 and 2015. A total of 130 infants met the inclusion criteria and were stratified into three groups based on their respiratory status at 36 weeks of gestational age: group A—oxygen (O2), group B—assisted ventilation (AV), group C—both O2 and AV. NICU clinical risk factors for readmission were assessed at set time points (6/12/18/24 months). Reasons for readmission were assessed for the entire cohort and severe BPD subgroups.

Conclusion An NICU diagnosis of neurologic abnormality, necrotizing enterocolitis, invasive NICU infection, dysphagia, and O2 at NICU discharge differed between the three subgroups of severe BPD. The most common cause of readmission was viral respiratory tract infection. Inhaled steroid use remained stable over time, while oxygen use and diuretic use declined over time. Risk factors for readmission in the entire cohort included g-tube, O2 use, and diuretic use at 12 months. There was no significant difference in readmission rates between the three BPD subgroups.