Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence
Infants with the most severe forms of bronchopulmonary dysplasia (BPD) may require long-term invasive positive pressure ventilation for survival, therefore necessitating tracheostomy. Although life-saving, tracheostomy has also been associated with high mortality, postoperative complications, high r...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/9/2572 |
| _version_ | 1797581120718503936 |
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| author | Audrey N. Miller Edward G. Shepherd Amy Manning Humra Shamim Tendy Chiang George El-Ferzli Leif D. Nelin |
| author_facet | Audrey N. Miller Edward G. Shepherd Amy Manning Humra Shamim Tendy Chiang George El-Ferzli Leif D. Nelin |
| author_sort | Audrey N. Miller |
| collection | DOAJ |
| description | Infants with the most severe forms of bronchopulmonary dysplasia (BPD) may require long-term invasive positive pressure ventilation for survival, therefore necessitating tracheostomy. Although life-saving, tracheostomy has also been associated with high mortality, postoperative complications, high readmission rates, neurodevelopmental impairment, and significant caregiver burden, making it a highly complex and challenging decision. However, for some infants tracheostomy may be necessary for survival and the only way to facilitate a timely and safe transition home. The specific indications for tracheostomy and the timing of the procedure in infants with severe BPD are currently unknown. Hence, centers and clinicians display broad variations in practice with regard to tracheostomy, which presents barriers to designing evidence-generating studies and establishing a consensus approach. As the incidence of severe BPD continues to rise, the question remains, how do we decide on tracheostomy to provide optimal outcomes for these patients? |
| first_indexed | 2024-03-10T23:00:39Z |
| format | Article |
| id | doaj.art-b762bf5926df4d82808521ebd485e8e1 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T23:00:39Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-b762bf5926df4d82808521ebd485e8e12023-11-19T09:43:11ZengMDPI AGBiomedicines2227-90592023-09-01119257210.3390/biomedicines11092572Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of EvidenceAudrey N. Miller0Edward G. Shepherd1Amy Manning2Humra Shamim3Tendy Chiang4George El-Ferzli5Leif D. Nelin6Comprehensive Center for Bronchopulmonary Dysplasia, Department of Pediatrics, Division of Neonatology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USAComprehensive Center for Bronchopulmonary Dysplasia, Department of Pediatrics, Division of Neonatology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USADepartment of Otolaryngology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USADepartment of Otolaryngology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USADepartment of Otolaryngology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USAComprehensive Center for Bronchopulmonary Dysplasia, Department of Pediatrics, Division of Neonatology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USAComprehensive Center for Bronchopulmonary Dysplasia, Department of Pediatrics, Division of Neonatology, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43205, USAInfants with the most severe forms of bronchopulmonary dysplasia (BPD) may require long-term invasive positive pressure ventilation for survival, therefore necessitating tracheostomy. Although life-saving, tracheostomy has also been associated with high mortality, postoperative complications, high readmission rates, neurodevelopmental impairment, and significant caregiver burden, making it a highly complex and challenging decision. However, for some infants tracheostomy may be necessary for survival and the only way to facilitate a timely and safe transition home. The specific indications for tracheostomy and the timing of the procedure in infants with severe BPD are currently unknown. Hence, centers and clinicians display broad variations in practice with regard to tracheostomy, which presents barriers to designing evidence-generating studies and establishing a consensus approach. As the incidence of severe BPD continues to rise, the question remains, how do we decide on tracheostomy to provide optimal outcomes for these patients?https://www.mdpi.com/2227-9059/11/9/2572bronchopulmonary dysplasiatracheostomymortalitypulmonary outcomes |
| spellingShingle | Audrey N. Miller Edward G. Shepherd Amy Manning Humra Shamim Tendy Chiang George El-Ferzli Leif D. Nelin Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence Biomedicines bronchopulmonary dysplasia tracheostomy mortality pulmonary outcomes |
| title | Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence |
| title_full | Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence |
| title_fullStr | Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence |
| title_full_unstemmed | Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence |
| title_short | Tracheostomy in Severe Bronchopulmonary Dysplasia—How to Decide in the Absence of Evidence |
| title_sort | tracheostomy in severe bronchopulmonary dysplasia how to decide in the absence of evidence |
| topic | bronchopulmonary dysplasia tracheostomy mortality pulmonary outcomes |
| url | https://www.mdpi.com/2227-9059/11/9/2572 |
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