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Am J Perinatol 2024; 41(S 01): e536-e544
DOI: 10.1055/s-0042-1755589
Original Article

Approaches to Interdisciplinary Care for Infants with Severe Bronchopulmonary Dysplasia: A Survey of the Bronchopulmonary Dysplasia Collaborative

A. Ioana Cristea
1   Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
,
Michael C. Tracy
2   Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Stanford, California
,
Sarah E. Bauer
1   Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
,
Milenka Cuevas Guaman
3   Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
,
Stephen E. Welty
4   Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
,
Christopher D. Baker
5   Department of Pediatrics-Pulmonary Medicine, University of Colorado, Denver, Colorado
,
Shazia Bhombal
2   Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Stanford, California
,
Joseph M. Collaco
6   Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University, Baltimore, Maryland
,
Sherry E. Courtney
7   Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansa
,
Robert J. DiGeronimo
4   Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
,
Laurie C. Eldredge
4   Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
,
Kathleen Gibbs
8   Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
,
Lystra P. Hayden
9   Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
Martin Keszler 
10   Department of Pediatrics, Women and Infants Hospital, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
,
Khanh Lai
11   Department of Pediatrics, Intermountain Primary Children's Hospital, University of Utah, Salt Lake City, Utah
,
Sharon A. McGrath-Morrow
8   Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
,
Paul E. Moore
12   Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
,
Rebecca Rose
1   Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana
,
Richard Sindelar
13   Division of Neonatology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
,
William E. Truog
14   Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
,
Leif D. Nelin
15   Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
,
Steven Abman
5   Department of Pediatrics-Pulmonary Medicine, University of Colorado, Denver, Colorado
,
for the BPD Collaborative › Author Affiliations Funding None.
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Abstract

Objective Bronchopulmonary dysplasia (BPD) remains the most common late morbidity for extremely premature infants. Care of infants with BPD requires a longitudinal approach from the neonatal intensive care unit to ambulatory care though interdisciplinary programs. Current approaches for the development of optimal programs vary among centers.

Study Design We conducted a survey of 18 academic centers that are members of the BPD Collaborative, a consortium of institutions with an established interdisciplinary BPD program. We aimed to characterize the approach, composition, and current practices of the interdisciplinary teams in inpatient and outpatient domains.

Results Variations exist among centers, including composition of the interdisciplinary team, whether the team is the primary or consult service, timing of the first team assessment of the patient, frequency and nature of rounds during the hospitalization, and the timing of ambulatory visits postdischarge.

Conclusion Further studies to assess long-term outcomes are needed to optimize interdisciplinary care of infants with severe BPD.

Key Points

  • Care of infants with BPD requires a longitudinal approach from the NICU to ambulatory care.

  • Benefits of interdisciplinary care for children have been observed in other chronic conditions.

  • Current approaches for the development of optimal interdisciplinary BPD programs vary among centers.

Keywords

bronchopulmonary dysplasia - interdisciplinary care - neonatal intensive care unit - outpatient care

Note

We would like to confirm that this material is original research, has not been previously published, and has not been submitted for publication elsewhere while under consideration.


Supplementary Material



Publication History

Received: 20 April 2022

Accepted: 12 July 2022

Article published online:
07 December 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Stoll BJ, Hansen NI, Bell EF. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA 2015; 314 (10) 1039-1051
    CrossrefPubMedGoogle Scholar
  • 2 Horbar JD, Edwards EM, Greenberg LT. et al. Variation in performance of neonatal intensive care units in the United States. JAMA Pediatr 2017; 171 (03) e164396-e164396
    CrossrefPubMedGoogle Scholar
  • 3 Blencowe H, Cousens S, Oestergaard MZ. et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379 (9832): 2162-2172
    CrossrefPubMedGoogle Scholar
  • 4 World Health Organization Fact Sheet. Preterm Birth. 2018. Accessed December 22, 2020 at: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
    PubMedGoogle Scholar
  • 5 Patel RM. Short and long-term outcomes for extremely preterm infants. Am J Perinatol 2016; 33 (03) 318-328
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2017; 3: CD004454
    PubMedGoogle Scholar
  • 7 Soll RF. Prophylactic natural surfactant extract for preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2000; (02) CD000511
    PubMedGoogle Scholar
  • 8 Carlo WA, Finer NN, Walsh MC. et al; SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med 2010; 362 (21) 1959-1969
    CrossrefPubMedGoogle Scholar
  • 9 Vento M, Moro M, Escrig R. et al. Preterm resuscitation with low oxygen causes less oxidative stress, inflammation, and chronic lung disease. Pediatrics 2009; 124 (03) e439-e449
    CrossrefPubMedGoogle Scholar
  • 10 Rojas MA, Gonzalez A, Bancalari E, Claure N, Poole C, Silva-Neto G. Changing trends in the epidemiology and pathogenesis of neonatal chronic lung disease. J Pediatr 1995; 126 (04) 605-610
    CrossrefPubMedGoogle Scholar
  • 11 Charafeddine L, D'Angio CT, Phelps DL. Atypical chronic lung disease patterns in neonates. Pediatrics 1999; 103 (4, pt 1): 759-765
    CrossrefPubMedGoogle Scholar
  • 12 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729
    CrossrefPubMedGoogle Scholar
  • 13 Abman SH, Collaco JM, Shepherd EG. et al; Bronchopulmonary Dysplasia Collaborative. Interdisciplinary care of children with severe bronchopulmonary dysplasia. J Pediatr 2017; 181: 12-28.e1
    CrossrefPubMedGoogle Scholar
  • 14 Collaco JM, McGrath-Morrow SA. Respiratory phenotypes for preterm infants, children, and adults: bronchopulmonary dysplasia and more. Ann Am Thorac Soc 2018; 15 (05) 530-538
    CrossrefPubMedGoogle Scholar
  • 15 Wu KY, Jensen EA, White AM. et al. Characterization of disease phenotype in very preterm infants with severe bronchopulmonary dysplasia. Am J Respir Crit Care Med 2020; 201 (11) 1398-1406
    CrossrefPubMedGoogle Scholar
  • 16 Landry JS, Chan T, Lands L, Menzies D. Long-term impact of bronchopulmonary dysplasia on pulmonary function. Can Respir J 2011; 18 (05) 265-270
    CrossrefPubMedGoogle Scholar
  • 17 Baker CD, Alvira CM. Disrupted lung development and bronchopulmonary dysplasia: opportunities for lung repair and regeneration. Curr Opin Pediatr 2014; 26 (03) 306-314
    CrossrefPubMedGoogle Scholar
  • 18 Stuart BD, Sekar P, Coulson JD, Choi SE, McGrath-Morrow SA, Collaco JM. Health-care utilization and respiratory morbidities in preterm infants with pulmonary hypertension. J Perinatol 2013; 33 (07) 543-547
    CrossrefPubMedGoogle Scholar
  • 19 Mizuno K, Nishida Y, Taki M. et al. Infants with bronchopulmonary dysplasia suckle with weak pressures to maintain breathing during feeding. Pediatrics 2007; 120 (04) e1035-e1042
    CrossrefPubMedGoogle Scholar
  • 20 DeMauro SB, D'Agostino JA, Bann C. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Developmental outcomes of very preterm infants with tracheostomies. J Pediatr 2014; 164 (06) 1303-10.e2
    CrossrefPubMedGoogle Scholar
  • 21 Duncan S, Eid N. Tracheomalacia and bronchopulmonary dysplasia. Ann Otol Rhinol Laryngol 1991; 100 (10) 856-858
    CrossrefPubMedGoogle Scholar
  • 22 Baker CD, Abman SH, Mourani PM. Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol 2014; 27 (01) 8-16
    CrossrefPubMedGoogle Scholar
  • 23 Guaman MC, Gien J, Baker CD, Zhang H, Austin ED, Collaco JM. Point prevalence, clinical characteristics, and treatment variation for infants with severe bronchopulmonary dysplasia. Am J Perinatol 2015; 32 (10) 960-967
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Collaco JM, Agarwal A, Austin ED. et al. Characteristics of infants or children presenting to outpatient bronchopulmonary dysplasia clinics in the United States. Pediatr Pulmonol 2021; 56 (06) 1617-1625
    CrossrefPubMedGoogle Scholar
  • 25 McKinney RL, Napolitano N, Levin JJ. et al. Ventilatory strategies in infants with established severe bronchopulmonary dysplasia: a multicenter point prevalence study. J Pediatr 2022; 242: 248-252.e1
    CrossrefPubMedGoogle Scholar
  • 26 Thébaud B, Goss KN, Laughon M. et al. Bronchopulmonary dysplasia. Nat Rev Dis Primers 2019; 5 (01) 78
    CrossrefPubMedGoogle Scholar
  • 27 McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses' widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff (Millwood) 2011; 30 (02) 202-210
    CrossrefPubMedGoogle Scholar
  • 28 Gien J, Kinsella J, Thrasher J, Grenolds A, Abman SH, Baker CD. Retrospective analysis of an interdisciplinary ventilator care program intervention on survival of infants with ventilator-dependent bronchopulmonary dysplasia. Am J Perinatol 2017; 34 (02) 155-163
    PubMedGoogle Scholar
  • 29 Baker CD, Martin S, Thrasher J. et al. A standardized discharge process decreases length of stay for ventilator-dependent children. Pediatrics 2016; 137 (04) e20150637
    CrossrefPubMedGoogle Scholar
  • 30 Shepherd EG, Knupp AM, Welty SE, Susey KM, Gardner WP, Gest AL. An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations. J Perinatol 2012; 32 (01) 33-38
    CrossrefPubMedGoogle Scholar
  • 31 Smith VC, Zupancic JA, McCormick MC. et al. Rehospitalization in the first year of life among infants with bronchopulmonary dysplasia. J Pediatr 2004; 144 (06) 799-803
    PubMedGoogle Scholar
  • 32 Keller RL, Feng R, DeMauro SB. et al; Prematurity and Respiratory Outcomes Program. Bronchopulmonary dysplasia and perinatal characteristics predict 1-year respiratory outcomes in newborns born at extremely low gestational age: a prospective cohort study. J Pediatr 2017; 187: 89-97.e3
    CrossrefPubMedGoogle Scholar
  • 33 Jensen EA, Dysart K, Gantz MG. et al. The diagnosis of bronchopulmonary dysplasia in very preterm infants. An evidence-based approach. Am J Respir Crit Care Med 2019; 200 (06) 751-759
    CrossrefPubMedGoogle Scholar
  • 34 Vollsæter M, Clemm HH, Satrell E. et al. Adult respiratory outcomes of extreme preterm birth. A regional cohort study. Ann Am Thorac Soc 2015; 12 (03) 313-322
    CrossrefPubMedGoogle Scholar
  • 35 Simpson SJ, Logie KM, O'Dea CA. et al. Altered lung structure and function in mid-childhood survivors of very preterm birth. Thorax 2017; 72 (08) 702-711
    CrossrefPubMedGoogle Scholar
  • 36 Bui DS, Lodge CJ, Burgess JA. et al. Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life. Lancet Respir Med 2018; 6 (07) 535-544
    CrossrefPubMedGoogle Scholar
  • 37 Condren M, Boger JA. Impact of a pediatric clinic-based multidisciplinary asthma education and management program. J Pediatr Pharmacol Ther 2005; 10 (04) 254-258
    PubMedGoogle Scholar
  • 38 Chan DS, Callahan CW, Moreno C. Multidisciplinary education and management program for children with asthma. Am J Health Syst Pharm 2001; 58 (15) 1413-1417
    CrossrefPubMedGoogle Scholar
  • 39 Bocca G, Corpeleijn E, van den Heuvel ER, Stolk RP, Sauer PJ. Three-year follow-up of 3-year-old to 5-year-old children after participation in a multidisciplinary or a usual-care obesity treatment program. Clin Nutr 2014; 33 (06) 1095-1100
    CrossrefPubMedGoogle Scholar
  • 40 Nemet D, Ben-Haim I, Pantanowits M, Eliakim A. Effects of a combined intervention for treating severely obese prepubertal children. J Pediatr Endocrinol Metab 2013; 26 (1-2): 91-96
    CrossrefPubMedGoogle Scholar
  • 41 Svoren BM, Butler D, Levine B-S, Anderson BJ, Laffel LM. Reducing acute adverse outcomes in youths with type 1 diabetes: a randomized, controlled trial. Pediatrics 2003; 112 (04) 914-922
    CrossrefPubMedGoogle Scholar
  • 42 Lebecque P, Leonard A, De Boeck K. et al. Early referral to cystic fibrosis specialist centre impacts on respiratory outcome. J Cyst Fibros 2009; 8 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 43 Mahadeva R, Webb K, Westerbeek RC. et al. Clinical outcome in relation to care in centres specialising in cystic fibrosis: cross sectional study. BMJ 1998; 316 (7147): 1771-1775
    CrossrefPubMedGoogle Scholar
  • 44 Baraldi E, Filippone M. Chronic lung disease after premature birth. N Engl J Med 2007; 357 (19) 1946-1955
    CrossrefPubMedGoogle Scholar
  • 45 Um-Bergström P, Hallberg J, Pourbazargan M. et al. Pulmonary outcomes in adults with a history of bronchopulmonary dysplasia differ from patients with asthma. Respir Res 2019; 20 (01) 102
    CrossrefPubMedGoogle Scholar
  • 46 Svedenkrans J, Henckel E, Kowalski J, Norman M, Bohlin K. Long-term impact of preterm birth on exercise capacity in healthy young men: a national population-based cohort study. PLoS One 2013; 8 (12) e80869
    CrossrefPubMedGoogle Scholar
  • 47 Gough A, Linden M, Spence D, Patterson CC, Halliday HL, McGarvey LP. Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia. Eur Respir J 2014; 43 (03) 808-816
    CrossrefPubMedGoogle Scholar
  • 48 Stickland A, Clayton E, Sankey R, Hill CM. A qualitative study of sleep quality in children and their resident parents when in hospital. Arch Dis Child 2016; 101 (06) 546-551
    CrossrefPubMedGoogle Scholar
  • 49 Karnik A, Bonafide CP. A framework for reducing alarm fatigue on pediatric inpatient units. Hosp Pediatr 2015; 5 (03) 160-163
    CrossrefPubMedGoogle Scholar