118 5-year trends in Bronchopulmonary dysplasia (BPD) at a tertiary neonatal unit. (17th August 2022)

• Record Type: Journal Article
• Authors: Duncanson, Antoniece; Gruber, Melinda; Janakiraman, Sundaram; Nair, Vrinda; Loganathan, Prakash Kannan
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A133
• Page End: A133
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.216
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: To describe the incidence, risk factors and short-term hospital outcomes for varying severity of BPD. This would help us in designing local quality improvement project. Methods: We conducted a retrospective cohort study in a tertiary neonatal unit. Data were collected for five-year period (2016-2020) using neonatal electronic database and case notes. We included data on all preterm infants with birth gestational age ≤29 weeks either born in our center or received most of the intensive care treatment in our unit. We excluded infants with major congenital malformations or with more than 50% missing data. We defined BPD as any infant receiving respiratory support (mechanical ventilation, CPAP, high flow) or low flow oxygen to maintain oxygen saturation in the target range at 36 weeks of gestation and we defined Severe BPD as any infant receiving positive pressure respiratory support (mechanical ventilation, CPAP, high flow) maintain oxygen saturation in the target range at 36 weeks of gestation. Ethics approval was obtained (HRA & REC approval: 302448). All statistics were performed using SPSS software. Results: We had 185 preterm infants during the study period, with 32 babies died during the hospital stay, we had data on 153 infants available for final analysis. There were 31 out born babies during the study period (included for analysis). Table 1 provides trends in BPD, Severe BPD, and death over the 5-year period. There were no infants receiving invasive mechanical ventilation at 36 weeks. Generally, there was increasing trend in rates of BPD, Severe BPD and higher proportion of infants receiving CPAP/High flow at 36 weeks. Table 2 provides comparison of risk factors between infants with 'BPD' and infants with 'no BPD'. Overall, infants with diagnosis of BPD had lower birth gestational age and birth weight, received more ROP treatment, received longer duration of respiratory support, higher proportions were discharged on home oxygen and had a longer hospital stay duration (approximately 30 days longer stay). 29 (57%) of preterm infants of birth gestation ≥26 weeks were diagnosed with severe BPD. Conclusion: In our center we noticed increasing trend in diagnosis of BPD and severe BPD. Higher proportion of preterm infants with this diagnosis were discharged on home oxygen and had a longer hospital stay duration (approximately 30 days longer stay). More than half of preterm infants with a diagnosis of severe BPD was of birth gestation ≥26 weeks. We could not identify specific modifiable risk factors for BPD/severe BPD. Introduction of Quality improvement bundle would help in reducing the incidence of severe BPD/BPD.