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Development of an interdisciplinary tool to assess severe BPD phase of illness and application evaluating impact of

Kara H Mickas1,2, Manisha A Khakoo1,3, Kristen T Leeman4

  • 1Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 17, 2026
PubMed

Insights

A new scoring tool helps track progress in infants with severe bronchopulmonary dysplasia (sBPD). Tracheostomy improved scores, indicating a shift towards less severe illness phases for these infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Healthcare Quality Improvement

Background:

  • Infants with severe bronchopulmonary dysplasia (sBPD) experience distinct illness phases.
  • A novel longitudinal interdisciplinary assessment tool was developed to monitor infant progress.
  • The tool was subsequently used to evaluate the impact of tracheostomy on sBPD progression.

Purpose of the Study:

  • To create and validate a user-friendly, interdisciplinary scoring tool for assessing infants with sBPD.
  • To track longitudinal progress and align care goals between providers and families.
  • To evaluate the effect of tracheostomy placement on the illness phase of infants with sBPD.

Main Methods:

  • An iterative interview process with interprofessional experts was employed to develop the assessment tool for infants with grade 2/3 BPD.
  • Qualitative coding identified common themes, which were ranked by importance to finalize the tool's structure.
  • Retrospective pairwise score comparisons were conducted before and after tracheostomy placement.

Main Results:

  • The developed assessment tool comprises twelve categories aligned with four distinct illness phases.
  • Overall scores demonstrated improvement following tracheostomy placement.
  • Significant enhancements were observed in systemic steroid use, sedation, fraction of inspired oxygen (FiO2), weight gain, tolerance of care, and developmental participation.

Conclusions:

  • A practical, interdisciplinary scoring tool for sBPD is presented to facilitate aligned care goals and longitudinal progress tracking.
  • Tracheostomy placement correlated with a transition to less acute phases of severe bronchopulmonary dysplasia.
Abstract

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