Developmental Care Practices for Infants with Grade 3 Bronchopulmonary Dysplasia While in the Neonatal Intensive Care Unit.

Creator(s)

• Bridget DiPrisco
• Kristin Brinker
• Matt Coyle
• Tara DuPont
• Melissa Hanin
• Melissa House
• Megan Lagoski
• Audrey N. Miller
• Meaghan A. Ransom
• Laura Sillers
• Chelsea Wittwer, Children's Mercy Kansas CityFollow
• Audrey Wood
• Sara B. DeMauro

Document Type

Article

Publication Date

8-2026

Identifier

DOI: 10.1016/j.jpeds.2026.115157

Abstract

OBJECTIVE: To evaluate neurodevelopmental care practices for patients with grade 3 bronchopulmonary dysplasia (BPD), specifically the relationships between frequency of developmental therapies and types of developmentally supportive equipment provided to patients and the patient's current level of respiratory support, while still in the neonatal intensive care unit (NICU).

STUDY DESIGN: Cross-sectional study of 22 NICUs in the BPD Collaborative, including all eligible infants in each NICU with grade 3 BPD who had never been discharged home. We collected data about current respiratory support, neurodevelopmental therapies, and availability of developmentally supportive equipment in patients' rooms through the medical records and interviews with bedside nurses.

RESULTS: For this study 141 infants were included (median postmenstrual age 49 weeks, IQR 43-60 weeks). The majority (65.2%) were receiving invasive ventilation. Respiratory support was significantly associated with any physical therapy (P = .008) or speech therapy (P < .001) and total number of completed therapy sessions in the prior 48 hours (P < .001). Availability of developmentally supportive equipment in an infant's room was also significantly associated with respiratory support. Patients with tracheostomies had a notably higher count of many different types of developmentally supportive equipment in their rooms than those infants with endotracheal tubes and those receiving noninvasive respiratory support. The majority of nurses reported having time to support their patients' development (80%), but fewer than half the infants regularly experienced reading (37%) or singing (46%).

CONCLUSIONS: Developmental supports for infants with grade 3 BPD vary based on respiratory support and across institutions. Infants with tracheostomies have more opportunities for developmentally supportive activities. These data can be used to benchmark care practices across institutions and guide prospective studies to standardize developmental care and improve outcomes in infants with grade 3 BPD.

Journal Title

The Journal of pediatrics

Volume

295

First Page

115157

Last Page

115157

MeSH Keywords

Humans; Bronchopulmonary Dysplasia; Cross-Sectional Studies; Intensive Care Units, Neonatal; Infant, Newborn; Male; Female; Respiration, Artificial; Infant; Physical Therapy Modalities; Severity of Illness Index; Infant, Premature

PubMed ID

42190905

Keywords

neurodevelopmental impairment; occupational therapy; physical therapy; respiratory support; speech language therapy; tracheostomy

Recommended Citation

DiPrisco B, Brinker K, Coyle M, et al. Developmental Care Practices for Infants with Grade 3 Bronchopulmonary Dysplasia While in the Neonatal Intensive Care Unit. J Pediatr. 2026;295:115157. doi:10.1016/j.jpeds.2026.115157