Hyperinflation and its Association with Successful Transition to Home Ventilator Devices in Infants with Chronic Respiratory Failure and Severe Bronchopulmonary Dysplasia

Abstract Objective To estimate the association between lung hyperinflation and the time to successful transition to outpatient ventilators in infants with sBPD and chronic respiratory failure. Design/Methods: Infants with sBPD < 32 weeks’ gestation who received tracheostomies were identified. Hyperinflation was the main exposure. Time from tracheostomy to successful transition to the outpatient device was the main outcome. Kaplan-Meier and multivariable Cox proportional hazards were used to estimate the relationships between hyperinflation and the main outcome. Results Sixty-two infants were included; 26 (42%) were hyperinflated. Eleven died before transition, and 51 successfully transitioned. Hyperinflation was associated with both mortality (31% vs 8.3%, p = 0.02) and an increased duration (72 vs. 56 days) to successful transition (hazard ratio (HR) = 0.38, 95% CI: 0.19, 0.76, p = 0.006). Growth velocity was similar after tracheostomy placement. Conclusions In infants with chronic respiratory failure and sBPD < 32 weeks’ gestation, hyperinflation is related to mortality and inpatient morbidities.