Tracheostomy in infants with severe bronchopulmonary dysplasia: A review

Area of Science:

• Pediatrics
• Neonatology
• Respiratory Medicine

Background:

• Increased survival of infants with severe bronchopulmonary dysplasia (BPD) has led to a rise in long-term ventilation. This makes BPD the primary reason for tracheostomy in infants under one year old.
• Tracheostomy for severe BPD is increasingly common, with evidence suggesting potential benefits for respiratory and neurodevelopmental outcomes.

Purpose of the Study:

• To review current literature on tracheostomy for severe BPD in infants.
• To summarize indications, timing, and outcomes associated with tracheostomy in this population.
• To highlight variability in clinical management and follow-up care across different centers.

Main Methods:

• Systematic review of existing literature.
• Analysis of data on tracheostomy indications and timing.
• Examination of short- and long-term outcomes, including ventilator weaning, decannulation, rehospitalization, growth, and neurodevelopment.

Main Results:

• Tracheostomy in severe BPD may improve both short-term and long-term respiratory and neurodevelopmental outcomes.
• Significant variations exist among medical centers regarding tracheostomy indications, timing, intensive care, and post-discharge follow-up.
• Key outcomes like ventilator liberation, decannulation rates, rehospitalization, growth, and neurodevelopment are crucial for informed decision-making.

Conclusions:

• Tracheostomy is a common intervention for infants with severe BPD requiring long-term ventilation.
• Standardizing indications, timing, and follow-up care for tracheostomy in infants with severe BPD is essential.
• Further research is needed to optimize outcomes and guide clinical practice for this vulnerable population.