Prolonged Tracheal Intubation and the Association Between Patent Ductus Arteriosus and Bronchopulmonary Dysplasia: A Secondary Analysis of the PDA-TOLERATE trial

Abstract

In the PDA-TOLERATE trial, persistent (even for several weeks) moderate to large patent ductus arteriosus (PDA) was not associated with an increased risk of BPD when the infant required <10 days of intubation. However, in infants requiring intubation for ≥10 days, prolonged PDA exposure (≥11 days) was associated with an increased risk of moderate/severe BPD.

Keywords: bronchopulmonary dysplasia; patent ductus arteriosus; premature birth.

Figure 1;

online: Flow diagram of patient distribution in the PDA-TOLERATE trial: number of infants exposed to a moderate-to-large PDA shunt for <11 days or ≥11 days who were evaluated for BPD at 36 weeks post menstrual age.

Figure 2:

Relationship between PDA exposure and the outcomes BPD-any grade and BPD-grades 2 & 3 among infants intubated for <10 days or ≥10 days. The height of the bars represents the incidence of BPD-any grade. The clear portion of the bar represents the incidence of BPD grade 1. The solid portion of the bar represents the incidence of BPD grades 2 & 3.Infants exposed to a moderate-to-large PDA for ≥11 days were arbitrarily divided into 3 exposure subgroups (11–14 days, 15–20 days, and >20 days) to illustrate how incremental increases in exposure (beyond 10 days) affects the association between BPD and the presence of a persistent PDA.