BPD - Mortality
Introduction Pathogenesis Clinical Prevention Management Prognosis Growth Cardiovascular Pulmonary Neurodevelopmental Mortality References Abbreviations Other Lectures		BPD in the presurfactant era was associated with an overall mortality rate of 30-40%. Almost 80% of this occurred during the initial hospitalization, primarily from the progressive respiratory failure of the BPD itself. In fact, tools were developed to predict mortality in the chronically ventilated baby with BPD. Other causes of the inpatient mortality were pneumonia, sepsis, pulmonary hypertension and cor pulmonale and congestive heart failure. There was also a 10% post-NICU discharge mortality rate associated with the same causes. Most of the deaths occurred in the first year after discharge. Recent data, however, has shown a dramatic decline in mortality. In fact, several reports from the post-surfactant era indicate no deaths at all from BPD. Additionally, reports from the 1970s and 80s noted an increased risk of SIDS and ALTEs in babies with BPD. Sudden unexplained deaths were even reported in patients still hospitalized in the NICU. It became accepted practice to manage babies with home apnea monitors after NICU discharge, even though monitoring has never been shown to prevent SIDS. Later studies (post-surfactant) showed no increased risk of either SIDS or ALTE. It has been suggested that unrecognized episodes of hypoxia may be responsible for some of the reports of sudden death that occurred in BPD in the older literature. There is currently no consensus regarding the use of home apnea monitors in babies with BPD. Those discharged on oxygen should be on home oximeters; but only if there is also a history of recent or recurrent apnea should they also be on home apnea monitors. Return to top of page