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Continuous Neuromuscular Blockade for Bronchopulmonary Dysplasia
Emily D Johnson1, Kristopher Keppel2, LeAnn McNamara3
1Department of Nursing, Johns Hopkins Hospital, Baltimore, Maryland.
American Journal of Perinatology
|March 6, 2024
Summary
For premature infants with severe bronchopulmonary dysplasia (BPD), prolonged continuous neuromuscular blockade (CNMB) exceeding 25 days was associated with no survivors. This treatment did not improve linear growth and showed a high mortality rate.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a common complication in premature infants.
- Continuous neuromuscular blockade (CNMB) is used in severe BPD cases, but its impact on outcomes is unclear.
Purpose of the Study:
- To investigate the association between the duration of CNMB and mortality in infants with severe BPD.
- To evaluate the effect of CNMB on linear growth in infants with severe BPD.
Main Methods:
- A retrospective medical record review was conducted for children under 5 years old admitted between 2016 and 2022.
- The study included infants with BPD who received one or more courses of CNMB for at least 14 days.
Main Results:
- Twelve infants received CNMB for a median of 14-173 days. Most were born prematurely (<28 weeks gestation) and had low birth weights (<1000g).
- Only 2 out of 12 infants survived to discharge. Both survivors received CNMB for less than 25 days.
- Linear growth Z-scores decreased in most patients, and only one infant achieved a final length Z-score greater than -2.
Conclusions:
- No survivors were observed among infants with severe BPD receiving CNMB for 25 days or longer.
- Prolonged CNMB did not appear to improve linear growth in this cohort.
- These findings do not support the use of extended CNMB for mortality prevention in severe BPD.
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