Bronchopulmonary Dysplasia

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Hello! I was just wondering how often other NICUs see BPD! How severe does it get? What are your usual respiratory protocols? Do you oscillate more? Conventional vent? (Do you allow airleaks or do you upsize tubes?) HFNC? Bubble cpap/nasal cpap? Etc.

We see it pretty frequently in our kids, so I'm curious of the incidence elsewhere.

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We just don't see it anymore. Only in a few of our ex-micros who had a really rough respiratory course. If you're seeing a lot of it you guys might want to look at your numbers as far as the average # of days your kiddos are on ventilators. After we went to the Ensure research philosophy are numbers got soo much better. Intubate, surf, extubate to Sipap same day, and if the kid decompensates intubate early but extubate early, 24-48 hours after stabilization. If the kid is stable enough we tube up for leaks. I think RAM and SiPap has made a huge difference in reducing BPD.

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We just don't see it anymore. Only in a few of our ex-micros who had a really rough respiratory course. If you're seeing a lot of it you guys might want to look at your numbers as far as the average # of days your kiddos are on ventilators. After we went to the Ensure research philosophy are numbers got soo much better. Intubate surf, extubate to Sipap same day, and if the kid decompensates intubate early but extubate early, 24-48 hours after stabilization. If the kid is stable enough we tube up for leaks. I think RAM and SiPap has made a huge difference in reducing BPD.[/quote']

Interesting. We have a BPD NICU. I want to say 15-20 beds strictly devoted to those "big kids" with BPD. We are a nationally ranked top 10 NICU in a large pediatric facility, and we see it a lot. We have a rapid extubation protocol (I'm going to steal a copy of it tonight at work) and for our small babies we use bubbleCPAP or SiPap. We don't upsize tubes often (sometimes, I swear you can hear the baby cough around the tube! Ridiculous. They seem to just compensate with higher pressures for those kids we can't seem to extubate, but it's hard to say what came first...), we don't use true HFNC often (5-6L) and I've only heard of a RAM cannula. Granted, we see quite a lot of micro-preemies (management is so proud of our small baby protocol), so that could also play a role.

If you, or anyone reading this, happens to have great articles on BPD, send them my way:)

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