Increased Mean Airway Pressure Is Associated With Successful Transition to a Portable Home Ventilator in Patients With Grade 3 Bronchopulmonary Dysplasia
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: An estimated 23% of children with grade 3 bronchopulmonary dysplasia (BPD) require tracheostomy for long term positive pressure ventilation. Transition from an intensive care unit (ICU) ventilator to a portable home ventilator (PHV) is one of the key steps in the process of discharging a patient home. The objective of this study was to identify clinical factors and ventilator settings associated with successful transition to a PHV in infants with grade 3 BPD. STUDY DESIGN: We performed a retrospective record review of 74 ventilator-dependent infants with grade 3 BPD hospitalized at 15 centers within the BPD Collaborative who transitioned to PHV between March 2021 and March 2023. Hierarchical cluster analysis of patient demographics and ICU ventilator settings at the time of transition was identify similar groups and compare factors associated with successful transitions. RESULTS: Patients with higher mean airway pressure (MAP) on the PHV compared with the MAP on their ICU ventilator were more likely to successfully transition on the first attempt, had fewer days from their first attempt until successful transition, and transitioned at an earlier postmenstrual age than patients with a lower MAP on their PHV. Cluster analysis of baseline ICU ventilator settings did not predict successful transition to PHV. CONCLUSIONS: We conclude that higher PHV pressures may enable patients with severe BPD to transition to a PHV. Premature weaning of ventilator pressures may be associated with prolonged need for an ICU ventilator.
Source: Pediatric Pulmonology
DOI: 10.1002/ppul.71403
Authors: Robin L McKinney, Joseph M. Collaco, Amit Agarwal, Christopher D Baker, Manvi Bansal, Matthew Douglass, Pamela S Griffiths, Kathleen E. Hannan, Martin Keszler, Matthew J Kielt, Winston Manimtim, Sharon Mcgrath‐Morrow, Audrey Miller, Meaghan A Ransom, Roopa Siddaiah, Abhineet M Sharma, Joshua Tanzer, Laurie C Eldredge, the Bronchopulmonary Dysplasia Collaborative
Institutions: Brown University, Johns Hopkins University, Johns Hopkins Medicine, Baylor College of Medicine, Texas Children's Hospital, Arkansas Children's Research Institute, University of Colorado Anschutz, University of Colorado Denver, University of Southern California, Children's Hospital of Los Angeles, University of Utah, Phoenix Children's Hospital, University of Arizona College of Medicine- Phoenix, Nationwide Children's Hospital, The Ohio State University, Children's Mercy Hospital, University of Missouri–Kansas City, University of Pennsylvania, Vanderbilt University Medical Center, Penn State Health Children's Hospital, Penn State Milton S. Hershey Medical Center, University of Nebraska Medical Center, Seattle Children's Hospital, University of Washington
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417038310