Extracorporeal life support use in patients with bronchopulmonary dysplasia: A single center case series

Area of Science:

• Pediatric critical care medicine
• Neonatology
• Pulmonology

Background:

• Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants, often associated with increased respiratory morbidity.
• Patients with BPD requiring respiratory support are historically considered high-risk for extracorporeal life support (ECLS) due to concerns of mortality and post-procedure complications.

Purpose of the Study:

• To evaluate the outcomes of preterm pediatric patients diagnosed with BPD who required ECLS for respiratory failure.
• To compare the mortality and long-term neurodevelopmental outcomes of BPD patients undergoing ECLS with historical data of non-BPD patients.

Main Methods:

• A single-center retrospective review of patients under 2 years old, born prematurely (<32 weeks gestation) with BPD requiring ECLS for respiratory failure between January 2010 and June 2022.
• Collection of demographic, clinical, and ECLS-specific data.
• Assessment of neurodevelopmental and functional deficits (speech, language, feeding, cognitive, hearing, vision, motor) at a median follow-up of 42 months post-discharge.

Main Results:

• Nineteen patients met the inclusion criteria, with a median birth weight of 0.86 kg and gestational age of 26 weeks.
• Survival to decannulation was 78.9% (15/19), and survival to hospital discharge was 63.2% (12/19).
• Among survivors, 42% needed home oxygen, and 50% had neurodevelopmental/behavioral concerns at 1-year follow-up.

Conclusions:

• Preterm patients with BPD requiring ECLS demonstrate comparable mortality rates to non-BPD patients with respiratory failure.
• Long-term neurodevelopmental outcomes in this BPD cohort are also similar to those observed in non-BPD ECLS patients.
• Findings support considering ECLS for BPD patients and provide data for informed family counseling regarding risks and benefits.