Sedative use in infants with grade 3 bronchopulmonary dysplasia (BPD) and associations with neurodevelopmental therapies
BACKGROUND/OBJECTIVES: To characterize sedative and analgesic use in NICU patients with grade 3 bronchopulmonary dysplasia (BPD) in relation to respiratory support and neurodevelopmental therapies. SUBJECTS/METHODS: Point-prevalence survey across 22 NICUs of infants <24 months corrected age with grade 3 BPD who had never been discharged. Exclusions included recent sepsis, tracheostomy, or major surgery. Data were analyzed descriptively. RESULTS: Among 141 infants, 97 (69%) received ≥1 sedative within 48 hours; 73 (75%) received multiple (mean 2.8 ± 1.6). Alpha-agonizts (n=67) and benzodiazepines (n=65) were most common, with 27 infants receiving an alpha-agonist, opioid, and benzodiazepine combination. Sedative exposure and medication count correlated with higher respiratory support (p<0.001) and FiO₂ (r=0.28, p<0.01). Sedation was associated with fewer completed therapy sessions (z=3.3, p<0.001). CONCLUSION: Sedation and polypharmacy were frequent among infants with severe BPD and linked to reduced therapy participation, highlighting the need to assess prescribing rationale and neurodevelopmental impacts.
Authors
- Bridget DiPrisco
- Divya Rana (ORCID: https://orcid.org/0000-0002-3720-9495)
- Susan Gage
- Tara L. DuPont (ORCID: https://orcid.org/0000-0002-1159-5279)
- Audrey N. Miller (ORCID: https://orcid.org/0000-0001-6222-3515)
- Meaghan Ransom (ORCID: https://orcid.org/0000-0002-2535-4468)
- Sara B. DeMauro (ORCID: https://orcid.org/0000-0003-1647-4000)
- Melissa House (ORCID: https://orcid.org/0000-0003-1426-5889)
- Laura Sillers (ORCID: https://orcid.org/0000-0002-0484-4150)
- Gangaram G. Akangire (ORCID: https://orcid.org/0000-0001-7796-7672)
- Brianna K. Brei (ORCID: https://orcid.org/0000-0003-0481-3597)
- Melissa Hanin
- Karishma Rao
- Thomas J. Davis (ORCID: https://orcid.org/0000-0003-2744-6937)
- Khanh Lai
- Matthew Coyle
Institutions
- Children's Hospital of Orange County (US)
- Nationwide Children's Hospital (US)
- Children's Mercy Hospital (US)
- Children's Hospital of Philadelphia (US)
- Children's Hospital of Los Angeles (US)
- Emory University (US)
- University of Tennessee Health Science Center (US)
- Utah Department of Health (US)
- Vanderbilt University Medical Center (US)
Publication Details
- Journal
- Journal of Perinatology
- Published
- 2026-06-25
- DOI
- https://doi.org/10.1038/s41372-026-02761-3
- Primary Topic
- Neonatal Respiratory Health Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Children's Hospital of Philadelphia
- Vanderbilt University
- University of Pennsylvania
- Emory University
- Texas Children's Hospital
- Nationwide Children's Hospital
- Pennsylvania State University
- Children's Mercy Hospital
- Children's Healthcare of Atlanta