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Objective <p>To identify novel risk factors associated with tracheostomy in preterm infants with Grade 3 bronchopulmonary dysplasia (BPD).</p> Study design <p>Single-center retrospective cohort of infants with Grade 3 BPD (mechanical ventilation at 36 weeks’ postmenstrual age) from 2019 to 2025. Data included extubation attempts, corticosteroid and neuromuscular blockade use, mean airway pressure (MAP) and respiratory severity scores (RSS) at 36 and 40 weeks. Infants who received tracheostomy or died were compared to those successfully extubated.</p> Results <p>Of 60 infants, 37% underwent tracheostomy. Patients requiring tracheostomy had higher MAP (17 vs. 12 cm H₂O) and RSS (6 vs. 4) at 40 weeks, with no difference at 36 weeks. Patients requiring tracheostomy experienced more steroid courses, need for neuromuscular blockade, and failed extubations.</p> Conclusions <p>Number of steroid courses, neuromuscular blockade, and ventilator settings at 40 weeks were associated with tracheostomy placement. These variables could inform future data collection strategies for infants with severe BPD.</p>

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Identifying predictors of tracheostomy or death in preterm infants with grade 3 BPD

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • William Scott,
  • Kathryn Berlin,
  • Joanne Lagatta,
  • Ruby Gupta

摘要

Objective

To identify novel risk factors associated with tracheostomy in preterm infants with Grade 3 bronchopulmonary dysplasia (BPD).

Study design

Single-center retrospective cohort of infants with Grade 3 BPD (mechanical ventilation at 36 weeks’ postmenstrual age) from 2019 to 2025. Data included extubation attempts, corticosteroid and neuromuscular blockade use, mean airway pressure (MAP) and respiratory severity scores (RSS) at 36 and 40 weeks. Infants who received tracheostomy or died were compared to those successfully extubated.

Results

Of 60 infants, 37% underwent tracheostomy. Patients requiring tracheostomy had higher MAP (17 vs. 12 cm H₂O) and RSS (6 vs. 4) at 40 weeks, with no difference at 36 weeks. Patients requiring tracheostomy experienced more steroid courses, need for neuromuscular blockade, and failed extubations.

Conclusions

Number of steroid courses, neuromuscular blockade, and ventilator settings at 40 weeks were associated with tracheostomy placement. These variables could inform future data collection strategies for infants with severe BPD.