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Inhaled bronchodilator use for infants with bronchopulmonary dysplasia

J L Slaughter1, M R Stenger2, P B Reagan3

  • 11] The Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH, USA [2] The Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|August 8, 2014
PubMed

Insights

Bronchodilators are frequently given to infants with bronchopulmonary dysplasia (BPD), especially those requiring prolonged mechanical ventilation. Prescribing patterns for these treatments vary significantly between hospitals.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Clinical Pharmacy

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
  • Bronchodilator use in BPD is common but factors influencing administration and institutional variations are not well understood.

Purpose of the Study:

  • To identify factors associated with bronchodilator administration in infants with BPD.
  • To evaluate inter-institutional prescribing patterns of bronchodilators for BPD.

Main Methods:

  • Retrospective cohort study using the Pediatric Health Information System database.
  • Included infants born <29 weeks gestation with evolving BPD at 28 days.
  • Used random-effects logistic regression to control for confounding variables and assess between-hospital variation.

Main Results:

  • 33% of 1429 infants with BPD received bronchodilators.
  • Increased duration of mechanical ventilation (⩾54 days) significantly increased odds of bronchodilator use (OR 19.6).
  • Wide variation in bronchodilator use observed between hospitals (0% to 81%).

Conclusions:

  • Bronchodilators are frequently administered to infants with BPD in US children's hospitals.
  • Positive pressure ventilation exposure is a key predictor of bronchodilator use.
  • Significant institutional variation in bronchodilator frequency and duration exists, even after adjusting for confounders.
Abstract

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