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Updated: Jun 5, 2026

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
04:43

Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications

Published on: March 15, 2024

Reframing Risk: Intubation Time Outweighs Tracheostomy in Predicting Neurodevelopment in Severe BPD

Ben Hirsch1, Alexander Szymczak1, Ashley Young2

  • 1Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

The Laryngoscope
|June 4, 2026
PubMed

Insights

Prolonged intubation, not tracheostomy, is linked to poorer neurodevelopmental outcomes in infants with severe bronchopulmonary dysplasia (BPD). Further research is needed to see if early tracheostomy improves long-term results.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Neurodevelopmental Pediatrics

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant cause of chronic lung disease in premature infants, often necessitating prolonged respiratory support.
  • The impact of interventions like intubation and tracheostomy on neurodevelopmental outcomes in severe BPD patients is not fully understood.

Purpose of the Study:

  • To investigate the independent association between tracheostomy and neurodevelopmental outcomes in infants with severe BPD.
  • To differentiate the effects of tracheostomy from those of prolonged intubation on cognitive and motor development.

Main Methods:

  • Retrospective cohort study of infants with severe BPD (2001 NIH criteria) treated between 2011-2023.
  • Case-matching of tracheostomy-dependent (n=25) to non-tracheostomy-dependent (n=50) BPD patients by gestational age and sex.
  • Analysis of Bayley neurodevelopmental scores using univariate and multivariate regression, adjusting for relevant covariates.

Main Results:

  • Tracheostomy-dependent patients experienced significantly longer intubation durations (114 vs. 66 days).
  • Prolonged intubation (>50 days) was independently associated with lower Bayley cognitive (-8.49 points) and motor (-11.03 points) scores.
  • Tracheostomy status itself was not independently associated with cognitive or motor outcomes (p > 0.05).

Conclusions:

  • Prolonged intubation, rather than tracheostomy placement, is linked to adverse neurocognitive and motor outcomes in infants with severe BPD.
  • Prospective studies are warranted to explore if early tracheostomy, to reduce intubation duration, can enhance long-term neurodevelopmental outcomes.
Abstract

Keywords:
BPDinfantsintubationneurodevelopmenttracheostomy

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