Hyperinflation and its association with successful transition to home ventilator devices in infants with chronic respiratory failure and severe bronchopulmonary dysplasia

Objective: To estimate the association between lung hyperinflation and the time to successful transition to home 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 home ventilator 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.