Publications by authors named "Winston Manimtim"
Background: A history of atopy is associated with respiratory morbidities in term-born children; however, little is known about how allergies/atopy affect respiratory outcomes in children with bronchopulmonary dysplasia (BPD). This study aims to describe the prevalence of reported allergies/atopy in young children with BPD and assess whether allergies/atopy are associated with outpatient outcomes.
Methods: A retrospective longitudinal cohort study of children between 0 and 36 months of age followed at outpatient BPD clinics was performed using data from questionnaires administered during routine clinical encounters.
Objectives: To characterize an observational cohort of ventilator-dependent infants and children with bronchopulmonary dysplasia (BPD) with or without tracheobronchomalacia (TBM) and determine the impact of TBM on the need for ventilator support, liberation from the ventilator and tracheostomy decannulation.
Methods: Demographics and clinical outcomes were obtained by retrospective review from 12 centers participating in the outpatient BPD Collaborative registry. The cohort consisted of infants born between 2016 and 2021 who were dependent on invasive mechanical ventilation at home.
This study aimed to compare the accuracy of three newly proposed definitions of bronchopulmonary dysplasia (BPD) in predicting outcomes, and to investigate the impact of large airway versus parenchymal versus vascular BPD phenotypes on BPD outcomes.Retrospective chart review of 100 infants with severe BPD discharged from a Children's hospital between 2020 and 2021. Multivariable models evaluated the associations between BPD definitions and phenotypes with tracheostomy and death at 6 months and 1 year after NICU discharge.
View Article and Find Full Text PDFOutpatient clinical care for bronchopulmonary dysplasia: A survey of the BPD collaborative.
Pediatr Pulmonol
January 2025
Article Synopsis
- - The study focuses on bronchopulmonary dysplasia (BPD), a common chronic respiratory issue in infants, particularly those born preterm, highlighting the lack of consistent clinical care guidelines.
- - A survey of 27 BPD programs revealed significant variability in outpatient care, including referral processes, services offered, follow-up echocardiograms, and discharge criteria.
- - The authors advocate for the creation of comprehensive clinical guidelines for BPD, similar to those for asthma and cystic fibrosis, to standardize care and potentially improve long-term health outcomes.
Article Synopsis
- The study focused on ventilator-dependent infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) to assess their health outcomes.
- Approximately 60% of the 154 subjects had pulmonary hypertension, with many requiring specific medications; those with PH tended to transition to home ventilation and discharge at older ages.
- Despite the challenges, most subjects improved over time, successfully weaning off oxygen and ventilators by age 5, with a low mortality rate after discharge.
Article Synopsis
- The study aimed to assess the link between indoor air pollution and respiratory issues in children with bronchopulmonary dysplasia (BPD) under 3 years old.
- It involved 1,011 participants, with over 40% exposed to indoor pollutants like tobacco smoke and gas stoves, revealing higher odds of emergency visits and antibiotic use associated with secondhand smoke exposure.
- While acute respiratory problems were related to indoor air pollution, chronic respiratory symptoms and rescue medication use showed no significant association.
Article Synopsis
- The study aimed to identify factors affecting when infants with severe bronchopulmonary dysplasia (sBPD) can be liberated from ventilators and successfully decannulated.
- Results showed that on average, ventilation liberation occurred at 27 months and decannulation at 49 months, with factors like age at discharge, ventilator pressure, and respiratory readmissions influencing these timings.
- Conclusions highlighted that individual factors predominantly drive the differences in timing, while aggressive management of gastroesophageal reflux affected decannulation timelines.
Multidisciplinary bronchopulmonary dysplasia (BPD) programs provide improved and consistent medical management, care of the developing infant, family support, and smoother transitions in care resulting in improved survival, pulmonary, and extra-pulmonary outcomes. This review summarizes the benefits of interdisciplinary BPD management, as well as strategies for initial programmatic development, program growth, and maintenance at centers across the United States factoring in institutional, provider, and parent reported goals that were derived from a consensus conference on BPD management.
View Article and Find Full Text PDFObjective: To compare the cognitive, language and motor scores of infants with severe BPD exposed to postnatal corticosteroids (PCS) and had early (ET), late (LT) or no tracheostomy (NT).
Methods: Retrospective study was designed to compare the developmental outcomes of 71 infants born between 2010 and 2017 with severe BPD exposed to PCS and had ET (≤122 days), LT (>122 days), or NT.
Results: Cognitive scores were lower in LT versus NT and ET (p = 0.
Article Synopsis
- Bronchopulmonary dysplasia (BPD) is more common in premature infants and linked to increased outpatient health issues, especially with daycare attendance, prompting a study on the impact of other children in the household on these risks.
- A study involving 933 children with BPD revealed that each additional child in the household raises the risk for various respiratory-related health issues, such as hospital admissions and medication use, particularly when there are three or more children present.
- The findings suggest increased risks of adverse respiratory outcomes due to possible viral infections spreading among household members, indicating a need for strategies to reduce these risks.
Article Synopsis
- The study focuses on outpatient respiratory outcomes in children with severe bronchopulmonary dysplasia (BPD) who require tracheostomy and long-term mechanical ventilation.
- Researchers analyzed data from 155 patients born between 2016 and 2021 across 12 care centers, using methods like Kaplan-Meier analysis to track key respiratory events and assess timing differences among centers.
- Findings showed significant variability in outcomes such as age at tracheostomy, hospital discharge, and ventilator liberation across different centers, highlighting the need for further research to understand contributing factors to these differences.
Article Synopsis
- A standardized questionnaire was developed to assess respiratory control in preterm infants and children with bronchopulmonary dysplasia (BPD) during outpatient visits, addressing the lack of valid tools for this purpose.
- Most caregivers (86.2%) reported feeling their child's symptoms were controlled, regardless of BPD severity or history of pulmonary hypertension, indicating broad perceived stability across the population.
- The questionnaire proved internally reliable and effectively differentiated between levels of symptom control, correlating with healthcare utilization metrics like emergency visits and hospital admissions, suggesting it may be useful for clinical and research applications.
Tracheostomy in infants with severe bronchopulmonary dysplasia: A review.
Front Pediatr
January 2023
In recent years, with increased survival of infants with severe bronchopulmonary dysplasia (BPD), long term ventilation due to severe BPD has increased and become the most common indication for tracheostomy in infants less than one year of age. Evidence shows that tracheostomy in severe BPD may improve short- and long-term respiratory and neurodevelopmental outcomes. However, there is significant variation among centers in the indication, timing, intensive care management, and follow-up care after hospital discharge of infants with severe BPD who received tracheostomy for chronic ventilation.
View Article and Find Full Text PDFObjective: To describe the survival rate, timing of liberation from the ventilator, and factors favorable for decannulation among infants with severe bronchopulmonary dysplasia (sBPD) who received tracheostomy.
Methods: Demographics and clinical outcomes were obtained through retrospective chart review of 98 infants with sBPD who were born between 2004 and 2017, received tracheostomy at <1 year of age, and were followed in the Infant Tracheostomy and Home Ventilator clinic up to 4 years of age.
Results: The number of infants with sBPD who received tracheostomy increased significantly over the study period.
Article Synopsis
- The study aimed to determine if daycare attendance increases chronic respiratory issues and healthcare usage in children with bronchopulmonary dysplasia (BPD).
- It involved 341 preterm infants with BPD, assessing their health outcomes and daycare attendance using structured assessments.
- Results indicated that those in daycare had more emergency visits, steroid use, and respiratory issues, particularly severe cases attending between 6-12 months, suggesting daycare could be a significant risk factor for respiratory problems in these children.
Article Synopsis
- Preterm infants and children with bronchopulmonary dysplasia (BPD) are at higher risk for respiratory issues and acute care visits, prompting the need to identify risk factors, particularly in those with public insurance like Medicaid.
- A study with 470 subjects found that children on Medicaid had significantly higher rates of sick visits, emergency department visits, and respiratory admissions compared to those with employer-based insurance.
- These findings suggest that Medicaid coverage may be linked to increased healthcare utilization and complications, highlighting the necessity for further research on socioeconomic factors and environmental influences on health outcomes in this population.
Objective: To measure short-term outcomes of neonates with congenital diaphragmatic hernia (CDH) while on Neurally Adjusted Ventilator Assist (NAVA), and to measure the impact of a congenitally abnormal diaphragm on NAVA ventilator indices.
Study Design: First, we conducted a retrospective-cohort analysis of 16 neonates with CDH placed on NAVA over a treatment period of 72 h. Second, we performed a case-control study comparing NAVA level and Edi between neonates with CDH and those without CDH.
Objective: To determine if multidisciplinary team-based care of severe BPD/CLD infants improve survival to discharge.
Design/methods: Retrospective review of severe BPD/CLD infants cared for by dedicated multidisciplinary CLD team using consensus-driven protocols and guidelines.
Results: Total of 267 patients.
Article Synopsis
- Bronchopulmonary dysplasia (BPD) is a common respiratory condition among preterm infants, but there's limited outpatient data on their management and outcomes.
- Seven specialty clinics provided data for a study involving 413 preterm infants, with many having severe BPD; notably, over half of the subjects were nonwhite.
- The study found that management approaches varied by clinic, but severity of BPD did not influence the use of acute care services, highlighting the role of follow-up care in respiratory outcomes for these children.
Introduction: Tracheostomy in children is often performed to alleviate airway obstruction (AO) or to facilitate long-term ventilator support due to respiratory failure of various etiologies, such as heart failure, and postoperative respiratory failure. Although many of these pathologies are common among trisomy 21 patients, tracheostomy rates among this population have not previously been reported. The aim of our study was to determine the incidence of trisomy 21 patients undergoing tracheostomy.
View Article and Find Full Text PDFBackground: Outcome of infants with tracheostomy have not been well described in the literature. Our objective was to describe the respiratory, growth, and survival outcomes of infants with tracheostomy.
Methods: A retrospective study was conducted on 204 infants born between 2005 and 2015 with tracheostomy at <1 year of age and follow-up in the Infant Tracheostomy and Home Ventilator Clinic up to 4 years of age.
Objective: The impact of tracheostomy on language and cognitive development in infants with severe bronchopulmonary dysplasia (BPD) is not known. We hypothesize that tracheostomy has an independent negative impact on language and cognitive development in infants with severe BPD.
Study Design: This is a retrospective cohort study of de-identified data of infants with severe BPD who received tracheostomy at <2 years of age, compared with infants with severe BPD without tracheostomy.
Hearing loss is the most common congenital birth defect. In 2007, American Academy of Pediatrics updated the hearing screen guidelines to recommend hearing screen by 1 month of age, diagnostic evaluation by 3 months, and early interventions by 6 months. Early interventions have been shown to improve developmental outcome in children with hearing loss.
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