December 4, 2025Open Access

Minimizing the Duration of Invasive Mechanical Ventilation to Prevent Bronchopulmonary Dysplasia: A Quality Improvement Approach

Key Points

BPD incidence decreased from 57.5% to 45.9% following quality improvement initiatives, improving infant outcomes.
During the intervention, standardized protocols significantly lowered invasive ventilation duration from 17.1 days to 7.2 days.
A multidisciplinary team implemented daily assessments and noninvasive surfactant administration to enhance care in a neonatal intensive care unit.
Multivariate logistic regression analysis identified duration of invasive ventilation as significantly associated with the risk of developing BPD.

Abstract

Purpose: Bronchopulmonary dysplasia (BPD) is a chronic lung disease and a major cause of morbidity in preterm infants, especially in those requiring prolonged invasive mechanical ventilation. This quality improvement (QI) initiative aimed to reduce the duration of invasive ventilation, thereby lowering the incidence of BPD in very-lowbirth-weight infants.Methods: A multidisciplinary QI initiative was conducted at the neonatal intensive care unit of Seoul National University Bundang Hospital from February 2022 to June 2024 and compared with historical controls from January 2019 to December 2021. Infants born at pppp=0.045). According to subgroup analysis of infants born at p=0.01), but BPD incidence was not significantly different (85.5% vs. 92.7%, p=0.27). In the multivariate logistic regression analysis, only the duration of invasive ventilation was significantly associated with BPD (odds ratio OR, 1.09; 95% confidence interval CI, 1.021 to 1.167; p=0.01), but not birth weight (OR, 0.997; 95% CI, 0.995 to 0.999; p=0.001).Conclusion: A structured multidisciplinary intervention effectively reduced the duration of invasive ventilation and BPD. Continued emphasis on comprehensive care bundles may further benefit premature infants.

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