1. Qualitative indications for tracheostomy and chronic mechanical ventilation in patients with severe bronchopulmonary dysplasia
- Author
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William E Truog, Huayan Zhang, Beth Haberman, Sara Mūnoz-Blanco, Joanne Lagatta, Erica Wymore, Leif D. Nelin, Nicolas F M Porta, Robert DiGeronimo, Karna Murthy, Joana Machry, Rashmin C. Savani, Sushmita Yallapragada, Shilpa Vyas-Read, Karin P Potoka, and Girija Natarajan
- Subjects
medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,Article ,Malacia ,Tracheostomy ,Severe BPD ,Intensive Care Units, Neonatal ,medicine ,Text messaging ,Humans ,In patient ,Intensive care medicine ,Child ,Bronchopulmonary Dysplasia ,Response rate (survey) ,Mechanical ventilation ,business.industry ,Respiration ,Infant, Newborn ,Obstetrics and Gynecology ,Infant ,medicine.disease ,Respiration, Artificial ,Pediatrics, Perinatology and Child Health ,business ,Airway ,Severe Bronchopulmonary Dysplasia ,Infant, Premature - Abstract
BACKGROUND The decision to pursue chronic mechanical ventilation involves a complex mix of clinical and social considerations. Understanding the medical indications to pursue tracheostomy would reduce the ambiguity for both providers and families and facilitate focus on appropriate clinical goals. OBJECTIVE To describe potential indications to pursue tracheostomy and chronic mechanical ventilation in infants with severe BPD (sBPD). STUDY DESIGN We surveyed centers participating in the Children's Hospitals Neonatal Consortium to describe their approach to proceed with tracheostomy in infants with sBPD. We requested a single representative response per institution. Question types were fixed form and free text responses. RESULTS The response rate was high (31/34, 91%). Tracheostomy was strongly considered when: airway malacia was present, PCO2 ≥ 76-85 mmHg, FiO2 ≥ 0.60, PEEP ≥ 9-11 cm H2O, respiratory rate ≥ 61-70 breaths/min, PMA ≥ 44 weeks, and weight
- Published
- 2021