Dynamic PEEP Study: A Non-invasive Diagnostic Exam to Assess for Effective PEEP in Children with Severe BPD

Cassie Montoya; Robin Steinhorn; John Berger; Harutyun Haroyan; Mariam Said; Geovanny F. Perez

doi:10.1007/s00408-021-00497-9

Dynamic PEEP Study: A Non-invasive Diagnostic Exam to Assess for Effective PEEP in Children with Severe BPD

Cassie Montoya, Robin Steinhorn, John Berger, Harutyun Haroyan, Mariam Said, Geovanny F. Perez^*

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Objective: Tracheobronchomalacia (TBM) is common in neonates with bronchopulmonary dysplasia (BPD) and is associated with higher morbidity. This study evaluates the value of a CT protocol to assess the degree of TBM and gauge the adequacy of prescribed PEEP. Study Design: Four infants with severe BPD on invasive mechanical ventilation underwent a chest CT protocol, including limited reduced-dose expiratory scans with varying PEEP levels. Results: Baseline PEEP was adjusted in all subjects after performing the Dynamic PEEP CT. In two infants, the PEEP was increased due to significant TBM and in the other two without signs of TBM PEEP was decreased. The clinical course improved in all patients after adjusting PEEP. Conclusion: A “Dynamic PEEP” study may be reliable and non-invasive imaging modality for the evaluation of adequate ventilator settings in infants with severe BPD who are not optimal candidates for bronchoscopy.

Original language	English (US)
Pages (from-to)	59-65
Number of pages	7
Journal	Lung
Volume	200
Issue number	1
DOIs	https://doi.org/10.1007/s00408-021-00497-9
State	Published - Feb 2022

Keywords

Bronchopulmonary dysplasia
PEEP
Pulmonary hypertension
Pulmonary vein stenosis
Tracheomalacia

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00408-021-00497-9

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title = "Dynamic PEEP Study: A Non-invasive Diagnostic Exam to Assess for Effective PEEP in Children with Severe BPD",

abstract = "Objective: Tracheobronchomalacia (TBM) is common in neonates with bronchopulmonary dysplasia (BPD) and is associated with higher morbidity. This study evaluates the value of a CT protocol to assess the degree of TBM and gauge the adequacy of prescribed PEEP. Study Design: Four infants with severe BPD on invasive mechanical ventilation underwent a chest CT protocol, including limited reduced-dose expiratory scans with varying PEEP levels. Results: Baseline PEEP was adjusted in all subjects after performing the Dynamic PEEP CT. In two infants, the PEEP was increased due to significant TBM and in the other two without signs of TBM PEEP was decreased. The clinical course improved in all patients after adjusting PEEP. Conclusion: A “Dynamic PEEP” study may be reliable and non-invasive imaging modality for the evaluation of adequate ventilator settings in infants with severe BPD who are not optimal candidates for bronchoscopy.",

keywords = "Bronchopulmonary dysplasia, PEEP, Pulmonary hypertension, Pulmonary vein stenosis, Tracheomalacia",

author = "Cassie Montoya and Robin Steinhorn and John Berger and Harutyun Haroyan and Mariam Said and Perez, {Geovanny F.}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

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doi = "10.1007/s00408-021-00497-9",

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T1 - Dynamic PEEP Study

T2 - A Non-invasive Diagnostic Exam to Assess for Effective PEEP in Children with Severe BPD

AU - Montoya, Cassie

AU - Steinhorn, Robin

AU - Berger, John

AU - Haroyan, Harutyun

AU - Said, Mariam

AU - Perez, Geovanny F.

PY - 2022/2

Y1 - 2022/2

N2 - Objective: Tracheobronchomalacia (TBM) is common in neonates with bronchopulmonary dysplasia (BPD) and is associated with higher morbidity. This study evaluates the value of a CT protocol to assess the degree of TBM and gauge the adequacy of prescribed PEEP. Study Design: Four infants with severe BPD on invasive mechanical ventilation underwent a chest CT protocol, including limited reduced-dose expiratory scans with varying PEEP levels. Results: Baseline PEEP was adjusted in all subjects after performing the Dynamic PEEP CT. In two infants, the PEEP was increased due to significant TBM and in the other two without signs of TBM PEEP was decreased. The clinical course improved in all patients after adjusting PEEP. Conclusion: A “Dynamic PEEP” study may be reliable and non-invasive imaging modality for the evaluation of adequate ventilator settings in infants with severe BPD who are not optimal candidates for bronchoscopy.

AB - Objective: Tracheobronchomalacia (TBM) is common in neonates with bronchopulmonary dysplasia (BPD) and is associated with higher morbidity. This study evaluates the value of a CT protocol to assess the degree of TBM and gauge the adequacy of prescribed PEEP. Study Design: Four infants with severe BPD on invasive mechanical ventilation underwent a chest CT protocol, including limited reduced-dose expiratory scans with varying PEEP levels. Results: Baseline PEEP was adjusted in all subjects after performing the Dynamic PEEP CT. In two infants, the PEEP was increased due to significant TBM and in the other two without signs of TBM PEEP was decreased. The clinical course improved in all patients after adjusting PEEP. Conclusion: A “Dynamic PEEP” study may be reliable and non-invasive imaging modality for the evaluation of adequate ventilator settings in infants with severe BPD who are not optimal candidates for bronchoscopy.

KW - Bronchopulmonary dysplasia

KW - PEEP

KW - Pulmonary hypertension

KW - Pulmonary vein stenosis

KW - Tracheomalacia

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Dynamic PEEP Study: A Non-invasive Diagnostic Exam to Assess for Effective PEEP in Children with Severe BPD

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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