Discharge Practices for Infants with Bronchopulmonary Dysplasia: A Survey of National Experts - 15/03/23
, Chandler A. Annesi, BS 3, David N. Williams, PhD 4, Steven H. Abman, MD 5, Sharon A. McGrath-Morrow, MD, MBA 6, Leif D. Nelin, MD 7, Catherine A. Sheils, MD 1, Lystra P. Hayden, MD, MMSc 1on behalf of
the Bronchopulmonary Dysplasia Collaborative Expert Panel on Discharge Practices∗
Abstract |
Objective |
To establish consensus practices among a panel of national experts for the discharge of premature infants with bronchopulmonary dysplasia (BPD) from the hospital to home.
Study design |
We conducted a Delphi study that included US neonatologists and pediatric pulmonologists from the Bronchopulmonary Dysplasia Collaborative to establish consensus practices—defined as recommendations with at least 80% agreement—for infants with BPD being discharged from the hospital. Specifically, we evaluated recommendations for diagnostic tests to be completed around discharge, follow-up respiratory care, and family education.
Results |
Thirty-one expert participants completed 3 rounds of surveys, with a 99% response rate (92 of 93). Consensus was established that infants with moderate-severe BPD (ie, those who remain on respiratory support at 36 weeks) and those discharged on oxygen should be targeted for in-person pulmonary follow-up within 1 month of hospital discharge. Specialized neonatal follow-up is an alternative for infants with mild BPD. Infants with moderate or severe BPD should have an echocardiogram performed after 36 weeks to screen for pulmonary hypertension. Infants with BPD warrant additional evaluations if they have growth restriction or poor growth, pulmonary hypertension, or tachypnea and if they are discharged to home on oxygen, diuretics, or nonoral feeds.
Conclusions |
This Delphi survey establishes expert consensus around best practices for follow-up respiratory management and routine evaluation for infants with BPD surrounding neonatal discharge. Areas of disagreement for which consensus was not established are discussed.
Le texte complet de cet article est disponible en PDF.Keywords : Delphi survey, chronic lung disease of prematurity, neonatal transitions of care
Abbreviations : BPD, IUGR, NICU, PMA
Plan
| This project was supported by National Heart, Lung and Blood Institute (NHLBI) Grant K23 HL136851 (to L.H.) and the Boston Children's Hospital Medical Staff Organization's 2020 House Officer Development Award (to J.L.). Neither the National Institutes of Health (NIH) nor the Boston Children's Hospital Medical Staff Organization had any role in the study design, data collection, data analysis, interpretation of the data, manuscript preparation, or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHLBI or the NIH. The authors declare no conflicts of interest. |
Vol 253
P. 72 - février 2023 Retour au numéro
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