Date of Award
Medical Doctor (MD)
We hypothesized that early intubation would decrease the hazard of BPD and BPD/death in premature infants regardless of need for reintubation. Specific aims included assessing rates of BPD and BPD/death in infants first extubated between day of life (DOL)1-3 versus 4-7, 8+ and impact of re-intubation. We included infants with gestational age ≤28weeks, birth weight ≤1000g, and intubation on DOL1. Proportional hazards regression modeled time to BPD and BPD/death, adjusting for potential confounders. Of 262 infants, 101 (38.55%), 41 (15.65%) and 120 (45.80%) were extubated between DOL1-3, 4-7, and 8+, respectively. Extubation between DOL4-7 versus DOL1-3 was associated with an increased hazard of developing BPD (HR 1.7; 95%CI 1.0-2.8; p<0.05). Extubation on DOL 8+ was associated with a significantly increased hazard compared to extubation between DOL1-3 (16.9; 10.5-27.1; <0.0001) or DOL4-7 (10.0; 6.1-16.3; < 0.0001). Similar results were noted with BPD/death. Re-intubation did not affect BPD and BPD/death. Delaying extubation beyond the first 3 and 7 days was associated with an increased risk of BPD and BPD/death. Re-intubation did not impact outcomes.
Berger, Jessica, "Environmental And Genetic Risk Factors For Bronchopulmonary Dysplasia In Neonates" (2014). Yale Medicine Thesis Digital Library. 1859.