Browsing by Subject "BPD"

Now showing 1 - 2 of 2
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    Adjusting ventilator settings to avoid air trapping in extremely premature infants reduces the need for tracheostomy and length of stay
    (Frontiers, 2022-12-30) Sammour, Ibrahim; Conlon, Steven M.; Bauer, Sarah E.; Montgomery, Gregory S.; Cristea, A. Ioana; Rose, Rebecca S.; Pediatrics, School of Medicine
    Despite the improving understanding of how lung mechanics and tidal volume requirements evolve during the evolution of bronchopulmonary dysplasia (BPD), clinical management continues to be heterogeneous and inconsistent at many institutions. Recent reports have examined the use of high tidal-volume low respiratory rate strategies in these patients once disease has been well established to help facilitate their eventual extubation and improve their long-term neurodevelopmental outcomes. In this retrospective observational research study, we describe how intentional adjustment of ventilator settings based on patient lung mechanics by an interdisciplinary BPD team improved the care of the at-risk population of infants, reduced the need for tracheostomies, as well as length of stay over a period of over 3 years. The team aimed to establish consistency in the management of these children using a high tidal volume, low-rate approach, and titrating PEEP to address the autoPEEP and bronchomalacia that is frequently observed in this patient population.
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    Ventilatory Strategies in Infants with Established Severe Bronchopulmonary Dysplasia: A Multicenter Point Prevalence Study
    (Elsevier, 2022) McKinney, Robin L.; Napolitano, Natalie; Levin, Jonathan J.; Kielt, Matthew J.; Abman, Steven H.; Cuevas Guaman, Milenka; Rose, Rebecca S.; Courtney, Sherry E.; Matlock, David; Agarwal, Amit; Leeman, Kristen T.; Sanlorenzo, Lauren A.; Sindelar, Richard; Collaco, Joseph M.; Baker, Christopher D.; Hannan, Kathleen E.; Douglass, Matthew; Eldredge, Laurie C.; Lai, Khanh; McGrath-Morrow, Sharon A.; Tracy, Michael C.; Truog, William; Lewis, Tamorah; Murillo, Anarina L.; Keszler, Martin; BPD Collaborative; Pediatrics, School of Medicine
    We performed a point prevalence study on infants with severe bronchopulmonary dysplasia (BPD), collecting data on type and settings of ventilatory support; 187 infants, 51% of whom were on invasive positive-pressure ventilation (IPPV), from 15 centers were included. We found a significant center-specific variation in ventilator modes.