Improved growth and developmental activity post tracheostomy in preterm infants with severe BPD

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Surgical Neonatology

Background:

• Severe bronchopulmonary dysplasia (BPD) poses significant challenges to infant growth and development.
• Tracheostomy is a critical intervention for managing severe BPD, but its impact on growth and developmental participation requires further investigation.

Purpose of the Study:

• To evaluate the effects of tracheostomy on growth parameters, sedation requirements, and participation in developmental activities in infants with severe BPD.
• To compare pre-tracheostomy and post-tracheostomy outcomes in a cohort of high-risk infants.

Main Methods:

• Retrospective analysis of 72 infants with severe BPD who underwent tracheostomy between 2010 and 2016.
• Comparison of growth metrics (weight, length, head circumference) and physical therapy session frequency/type during the 4 weeks before and after tracheostomy tube change.

Main Results:

• Significant improvements in average weekly weight, length, and head circumference gain post-tracheostomy.
• Enhanced linear growth and improved Z scores for weight, length, and weight-to-length ratio after tracheostomy.
• Increased participation in developmental therapies (5.2 to 8.7 sessions/4 weeks) and decreased daily sedation requirements.

Conclusions:

• Tracheostomy is associated with improved proportional growth in preterm infants with severe BPD.
• The procedure enhances participation in developmental skill-building activities and reduces the need for daily sedation.
• Tracheostomy positively impacts multiple key outcomes for infants with severe BPD, supporting their overall development and physiological stability.