Post-N/IICU Inpatient BPD Clinical Pathway

Patient Cohort

This pathway applies to N/IICU and Complex Care Blue patients with the diagnosis of severe BPD.

Pathway Eligibility Criteria Include All the Following:

  • Infants with severe BPD
  • Transferring to Complex Care Blue service
  • On ≤ 4 LPM high flow nasal cannula (HFNC)

Exclusion Criteria

  • Patients who require continuous non-invasive ventilation or > 4 LPM HFNC
  • Patients who are under consideration for tracheostomy
  • Patients with critical airway

Diagnostic Criteria for BPD

Both criteria must be present to make a diagnosis of BPD

  • Gestational age at birth < 32 weeks AND
  • Ongoing respiratory support at a postmenstrual age (PMA) of 36 weeks

Grading Severity of BPD

Grading BPD severity is based on mode of respiratory support administered at 36 weeks PMA irrespective of the amount of supplemental oxygen.

There are multiple definitions available to diagnose BPD
These definitions are data-driven and linked to patient outcomes.
A comparison of the performance of this definition to others in the literature is available in the publication by Jensen et al:
The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach  

Inpatient, ICU Pathway for Pulmonary Hypertension Screening in Patients with BPD