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Retrospective Analysis of an Interdisciplinary Ventilator Care Program Intervention on Survival of Infants with

Jason Gien1, John Kinsella1, Jodi Thrasher2

  • 1Pediatric Heart Lung Center, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

American Journal of Perinatology
|June 30, 2016
PubMed

Insights

An interdisciplinary ventilator care program (VCP) significantly improved survival rates for infants with severe bronchopulmonary dysplasia (BPD) requiring mechanical ventilation. This standardized approach enhanced care and communication, leading to better outcomes.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Infants with severe bronchopulmonary dysplasia (BPD) requiring mechanical ventilation present complex clinical challenges.
  • Management strategies for optimizing survival and long-term outcomes in this population remain controversial.
  • An interdisciplinary ventilator care program (VCP) was hypothesized to improve survival through standardized care and enhanced communication.

Purpose of the Study:

  • To evaluate the impact of an interdisciplinary VCP on survival rates in ventilator-dependent infants with severe BPD.
  • To assess changes in management strategies and comorbidities before and after VCP implementation.
  • To determine if a standardized approach improves outcomes for critically ill infants.

Main Methods:

  • Retrospective chart review of infants undergoing tracheostomy between 2000 and 2013 at Children's Hospital Colorado.
  • Data collected included gestational age, age at tracheostomy, respiratory severity score (RSS), comorbidities, medication use, and age of death.
  • Patients were divided into two periods: before (2000-2005) and after (2006-2013) VCP initiation; severe BPD patients without tracheostomy were excluded.

Main Results:

  • Survival to discharge significantly increased from 50% to 85% after VCP implementation (p < 0.05).
  • No significant differences were observed in gestational age, birth weight, or cardiorespiratory comorbidities between the two periods.
  • Changes in systemic/inhaled steroid use and mucolytic use were noted between the study periods.

Conclusions:

  • An interdisciplinary approach to ventilator care for infants with severe BPD can significantly improve survival rates.
  • Standardized care protocols and enhanced communication within a VCP are crucial for managing this complex patient population.
  • The findings support the implementation of specialized, multidisciplinary programs for ventilator-dependent infants with BPD.

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