What does this research mean for the field?

Fentanyl exposure during mechanical ventilation in preterm neonates is associated with an increased risk of bronchopulmonary dysplasia and longer duration of invasive ventilation, with a potential risk threshold around 3 days of continuous infusion. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether fentanyl exposure during mechanical ventilation is associated with adverse respiratory outcomes in preterm neonates under 34 weeks and explore duration-response risk thresholds.

August 22, 2026Journal of Clinical MedicineOpen Access

Fentanyl Exposure Is Associated with Adverse Respiratory Outcomes in Ventilated Preterm Neonates: A Retrospective Matched Cohort Study

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To determine whether fentanyl exposure during mechanical ventilation is associated with adverse respiratory outcomes in preterm neonates under 34 weeks and explore duration-response risk thresholds.
Conducted a single-center retrospective matched cohort study (2015–2022, Rome) matching 50 fentanyl-exposed neonates to 92 unexposed controls (N=142) on gestational age and birth-weight z-score.
Analyzed primary outcome of bronchopulmonary dysplasia at 36 weeks postmenstrual age and duration of invasive mechanical ventilation using multivariable logistic regression.
Identified exposure duration thresholds for a composite adverse outcome (bronchopulmonary dysplasia or invasive ventilation ≥7 days) using restricted cubic splines and segmented logistic regression.
Fentanyl exposure was significantly associated with higher odds of bronchopulmonary dysplasia (adjusted OR 5.49, 95% CI 1.72–17.54) after controlling for gestational age and fetal distress.
Exposed neonates experienced significantly longer durations of invasive mechanical ventilation compared to controls (adjusted exp(β) 2.25, 95% CI 1.54–3.29).
Threshold analyses identified an exploratory signal of heightened respiratory risk occurring after approximately 3 days of continuous fentanyl infusion.

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Implication

Retrospective matched cohort study finds fentanyl exposure increases bronchopulmonary dysplasia in ventilated preterm neonates, suggesting cautious limiting of continuous infusion durations.

Cite This Study

Chiara et al. (2026) studied this question.

synapsesocial.com/papers/6a89600eca7ade938187f090 https://doi.org/10.3390/jcm15166457

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Implication

Retrospective matched cohort study finds fentanyl exposure increases bronchopulmonary dysplasia in ventilated preterm neonates, suggesting cautious limiting of continuous infusion durations.

Fentanyl Exposure Is Associated with Adverse Respiratory Outcomes in Ventilated Preterm Neonates: A Retrospective Matched Cohort Study

Key Points

Discussion

Implication

Cite This Study

Fentanyl Exposure Is Associated with Adverse Respiratory Outcomes in Ventilated Preterm Neonates: A Retrospective Matched Cohort Study

Key Points

Discussion

Implication

Cite This Study

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