Cargando…
The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia
During the COVID-19 pandemic, institutions developed ventilator allocation models. In one proposed model, neonates compete with adults for ventilators using a scoring system. Points are given for conditions that increase one- and five-year (y) mortality. For example, comparable points were added for...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452995/ https://www.ncbi.nlm.nih.gov/pubmed/37628402 http://dx.doi.org/10.3390/children10081404 |
_version_ | 1785095810417950720 |
---|---|
author | Sundaram, Anupama Fanaroff, Jonathan M. Wilson-Costello, Deanne Alberts, Melissa Shiswawala, Naini Stern, Noam Ryan, Rita M. |
author_facet | Sundaram, Anupama Fanaroff, Jonathan M. Wilson-Costello, Deanne Alberts, Melissa Shiswawala, Naini Stern, Noam Ryan, Rita M. |
author_sort | Sundaram, Anupama |
collection | PubMed |
description | During the COVID-19 pandemic, institutions developed ventilator allocation models. In one proposed model, neonates compete with adults for ventilators using a scoring system. Points are given for conditions that increase one- and five-year (y) mortality. For example, comparable points were added for adult conditions with mortality of 71.3% and for neonates with moderate or severe bronchopulmonary dysplasia (mod/sBPD). We hypothesized that this model overestimates mortality in neonates with BPD and would penalize these infants unfairly. There was little information available on 1 y and 5 y mortality risk for mod/sBPD. To evaluate this allocation protocol, a retrospective chart review was performed on infants born ≥22 weeks and weighing <1500 g admitted to Rainbow Babies and Children’s Hospital in 2015 to identify babies with BPD. The main outcomes were 1 and 5 y mortality. In 2015, 28 infants were diagnosed with mod/s BPD based on NIH 2001 definition; 4 infants had modBPD and 24 had sBPD. All infants (100%) with modBPD survived to 5 y; 2 infants with sBPD died by 1 y (8%) and 22 survived (92%) to 1 y; 3 died (12.5%) by 5 y; and at least 13 survived (54%) to 5 y. Infants with mod/s BPD had lower-than-predicted 1 and 5 y mortality, suggesting the points assigned in the model are too high for these conditions. We believe this model would unfairly penalize these babies. |
format | Online Article Text |
id | pubmed-10452995 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104529952023-08-26 The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia Sundaram, Anupama Fanaroff, Jonathan M. Wilson-Costello, Deanne Alberts, Melissa Shiswawala, Naini Stern, Noam Ryan, Rita M. Children (Basel) Article During the COVID-19 pandemic, institutions developed ventilator allocation models. In one proposed model, neonates compete with adults for ventilators using a scoring system. Points are given for conditions that increase one- and five-year (y) mortality. For example, comparable points were added for adult conditions with mortality of 71.3% and for neonates with moderate or severe bronchopulmonary dysplasia (mod/sBPD). We hypothesized that this model overestimates mortality in neonates with BPD and would penalize these infants unfairly. There was little information available on 1 y and 5 y mortality risk for mod/sBPD. To evaluate this allocation protocol, a retrospective chart review was performed on infants born ≥22 weeks and weighing <1500 g admitted to Rainbow Babies and Children’s Hospital in 2015 to identify babies with BPD. The main outcomes were 1 and 5 y mortality. In 2015, 28 infants were diagnosed with mod/s BPD based on NIH 2001 definition; 4 infants had modBPD and 24 had sBPD. All infants (100%) with modBPD survived to 5 y; 2 infants with sBPD died by 1 y (8%) and 22 survived (92%) to 1 y; 3 died (12.5%) by 5 y; and at least 13 survived (54%) to 5 y. Infants with mod/s BPD had lower-than-predicted 1 and 5 y mortality, suggesting the points assigned in the model are too high for these conditions. We believe this model would unfairly penalize these babies. MDPI 2023-08-17 /pmc/articles/PMC10452995/ /pubmed/37628402 http://dx.doi.org/10.3390/children10081404 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sundaram, Anupama Fanaroff, Jonathan M. Wilson-Costello, Deanne Alberts, Melissa Shiswawala, Naini Stern, Noam Ryan, Rita M. The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title | The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title_full | The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title_fullStr | The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title_full_unstemmed | The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title_short | The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia |
title_sort | pandemic allocation of ventilators model penalizes infants with bronchopulmonary dysplasia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452995/ https://www.ncbi.nlm.nih.gov/pubmed/37628402 http://dx.doi.org/10.3390/children10081404 |
work_keys_str_mv | AT sundaramanupama thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT fanaroffjonathanm thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT wilsoncostellodeanne thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT albertsmelissa thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT shiswawalanaini thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT sternnoam thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT ryanritam thepandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT sundaramanupama pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT fanaroffjonathanm pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT wilsoncostellodeanne pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT albertsmelissa pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT shiswawalanaini pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT sternnoam pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia AT ryanritam pandemicallocationofventilatorsmodelpenalizesinfantswithbronchopulmonarydysplasia |