Bronchopulmonary dysplasia: its relationship to invasive modes of ventilation and the magnitude of respiratory support.

Authors

Ronald I Clyman, Nancy K Hills, Elizabeth E Rogers, Nadra E Lisha

Published in

Journal of perinatology : official journal of the California Perinatal Association. Aug 11, 2026. Epub Aug 11, 2026.

Abstract

To determine whether the magnitude of respiratory support mediates the association between intubation/invasive ventilation and the incidence of bronchopulmonary dysplasia (BPD).
Observational study of BPD (diagnosed at 40 weeks' postmenstrual age) using Poisson regression and Mplus mediation analyses in 544 consecutively admitted inborn infants <28 weeks' gestation.
A change in guidelines emphasizing noninvasive ventilation led to a significant decrease in intubation rates. However, neither the magnitude of support nor the incidence of BPD-40 was decreased. While invasive ventilation at 1, 7 and 14 days was significantly associated with BPD-40 in multivariable regression and mediation analyses, its association appeared to be mediated by the magnitude of support (especially mean airway pressure), with no direct effect from the intubation/invasive ventilation.
Reducing intubation/invasive ventilation may not impact the rate of BPD-40 unless the infant's need for high levels of respiratory support (even if delivered noninvasively) is also minimized.

PMID:
42581159
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.

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