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To Trach or Not To Trach: Long-term Tracheostomy Outcomes in Infants with BPD
Matthew J Kielt1,2, Jonathan C Levin,
1Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH.
Insights
Tracheostomy placement for infants with bronchopulmonary dysplasia (BPD) is increasing, yet evidence-based guidelines are lacking. This review summarizes outcomes to aid family-centered counseling for this vulnerable population.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Medical Devices
Background:
- Infants born preterm with bronchopulmonary dysplasia (BPD) exhibit varied illness severity.
- Severe BPD cases may necessitate long-term ventilation via tracheostomy for hospital discharge.
- Tracheostomy placement rates are rising in infants with BPD, despite known risks.
Conclusions:
- There is a growing need for evidence-based guidelines on tracheostomy for infants with BPD.
- Further research on long-term outcomes is crucial for informed clinical practice.
- A family-centered approach is essential for counseling regarding tracheostomy placement.
Abstract:
See Bonus NeoBriefs videos and downloadable teaching slides Infants born preterm who are diagnosed with bronchopulmonary dysplasia (BPD) demonstrate a wide spectrum of illness severity. For infants with the most severe forms of BPD, safe discharge from the hospital may only be possible by providing long-term ventilation via a surgically placed tracheostomy. Though tracheostomy placement in infants with BPD is infrequent, recent reports suggest that rates of tracheostomy placement are increasing in this population. Even though there are known respiratory and neurodevelopmental risks associated with tracheostomy placement, no evidence-based criteria or consensus clinical practice guidelines exist to inform tracheostomy placement in this growing and vulnerable population. An incomplete knowledge of long-term post-tracheostomy outcomes in infants with BPD may unduly bias medical decision-making and family counseling regarding tracheostomy placement. This review aims to summarize our current knowledge of the epidemiology and long-term outcomes of tracheostomy placement in infants with BPD to provide a family-centered framework for tracheostomy counseling.
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