197 - The Effect of Continuous Neuromuscular Blockade in a Cohort of Patients with Grade 3 Bronchopulmonary Dysplasia

Poster Number: 197
Publication Number: 197.2875

Background: Bronchopulmonary Dysplasia (BPD) remains the most common complication of preterm birth and continues to occur despite significant improvements in neonatal care. Some patients with BPD develop life threatening hypoxia and/or hypercarbia and may receive continuous neuromuscular blockade (NMB) as part of therapy. There is minimal literature about the use of continuous NMB in these patients.

Objective: To describe the use and effect of continuous NMB in a single center cohort of patients with life threatening hypoxia and/or hypercarbia from Grade 3 BPD.

Design/Methods: We identified a cohort of patients with Grade 3 BPD who were followed by our interdisciplinary BPD team in our NICU and received continuous infusion vecuronium for greater than 48 hours between 1/1/2020 and 9/30/2023. We recorded the length of time on vecuronium, oxygen saturation index (OSI) before and after therapy, respiratory severity score (RSS) before and after therapy, the primary phenotype of BPD, and the outcome. This study was approved under institutional IRB.

Results: Twelve patients met criteria for inclusion in this cohort. Characteristics of the patients are depicted in Table 1. The median length of therapy was 10 days (range 3-17). All patients had decreases in OSI and RSS with therapy (Table 2). Two patients died while on therapy, five died after therapy (median = 18 days, range 7-140), and 5 are alive, all on chronic mechanical ventilation by tracheostomy. No patient with an EGA < 25 weeks survived. The percent change in OSI, percent change in RSS, and BPD phenotype were similar in patients who died versus patients who survived (Table 3).

Conclusion(s): In patients with life threatening hypoxia and/or hypercarbia, continuous NMB may decrease OSI and RSS, possibly increasing chances of survival. Larger cohorts which include neurodevelopmental assessments are needed to confirm these findings.