Coordinating Tracheostomy and Gastrostomy in Infants with Bronchopulmonary Dysplasia.

Abstract

Patients with bronchopulmonary dysplasia (BPD) often require both invasive respiratory support and durable enteral access. This study aims to identify variables associated with the concomitant placement of tracheostomy and gastrostomy tube (GT) in infants with BPD. Retrospective case-series study. Tertiary-care children's hospital. Demographic, clinical, and procedural variables were collected from the medical records of infants who underwent tracheostomy at age <2 between 1/2015 and 5/2024. Of 198 infants who underwent both tracheostomy and GT placement, 49 (24.7%) had BPD. Among these, median gestational age at birth was 25 weeks [IQR: 3], and age at tracheostomy was 6 months [IQR: 3]. Concomitant GT placement occurred in 21 (42.9%) of BPD patients. A short interval (≤30 days) between procedures was more common in BPD versus non-BPD patients (22.4% vs 11.4%, P < .001). Total time under anesthesia did not differ significantly when procedures were done concomitantly or staged (140 vs 156.5 min, P < .21). Concomitant placement was associated with a significantly shorter hospital stay (6.41 vs 9.42 months, P = .019). No significant differences were found in postoperative ileus, time to full feeds, or socioeconomic factors. In infants with BPD, the shorter time interval between tracheostomy and GT placement highlights an opportunity to further streamline care by coordinating these procedures at the same time. Our findings suggest that concomitant tracheostomy and GT placement are associated with comparable gastrointestinal complication rates and shorter hospital stays, supporting a combined surgical approach when feasible in this high-risk population.