Researchers identified specific milestones that help clinicians determine when infants with bronchopulmonary dysplasia (BPD) will no longer require respiratory support.


RT’s Three Key Takeaways:

  1. Data-Driven Milestones: Researchers analyzed data from more than 13,000 infants to identify weekly milestones that predict when babies with bronchopulmonary dysplasia (BPD) will likely transition off respiratory support.
  2. Support Mode Correlation: The type of respiratory support a patient receives at 36 weeks postmenstrual age (PMA) serves as a reliable indicator for the remaining duration of support needed.
  3. Clinical Intervention Indicators: Infants remaining on high flow nasal cannula at 40 weeks PMA or mechanical ventilation at 55 weeks PMA represent atypical cases that may require specialized referrals or adjustments in care plans.


Researchers at Children’s Hospital Los Angeles (CHLA) identified a method to predict when infants with bronchopulmonary dysplasia (BPD) will no longer require respiratory support, according to a study presented at the Pediatric Academic Societies 97th Annual Meeting.

The study analyzed records from more than 13,000 premature infants with BPD across 49 US children’s hospitals using the Pediatric Health Information System (PHIS) database. The findings provide weekly, data-backed milestones designed to help clinicians guide treatment and referral decisions.

“For the first time, we have a much clearer roadmap of what to expect,” said Narayan Iyer, MD, a neonatologist at CHLA and the study’s senior author. “Instead of relying on intuition, we can now reference real data to understand whether a baby’s progress is typical—or whether we need to adjust our approach.”

The research team found that the mode of respiratory support an infant receives at 36 weeks postmenstrual age (PMA) is a strong predictor of how many additional weeks of support will be required. The study also noted that remaining on the same type of breathing support at later PMAs is associated with significantly longer weaning times.

Two specific milestones were identified as critical checkpoints for neonatologists:

  • 40 weeks PMA: Most infants who utilize high flow nasal cannula at 36 weeks have typically transitioned off respiratory support by this point. If an infant remains on this support at 40 weeks, clinicians may need to reassess for complications, consider imaging or bronchoscopy, adjust therapies, or refer the patient to a specialized BPD center.
  • 55 weeks PMA: Most infants who require mechanical ventilation at 36 weeks have typically weaned by this time. If a baby remains ventilator dependent at 55 weeks PMA, the likelihood of weaning in the near future is low.

These findings are intended to assist in earlier conversations regarding tracheostomy, planning for home mechanical ventilation, and specialized referrals.

“Knowing when a baby is likely to come off respiratory support can not only guide key treatment decisions, but it can also help clinicians better answer the question every family asks: ‘When will my baby go home?’” said Iyer.

The research team is currently working to refine these predictions and investigate why certain infants require longer durations of breathing support. The goal is to enhance the ability of healthcare providers to personalize care and intervene earlier.

“These milestones give us actionable checkpoints,” said Iyer. “They help us recognize when a baby is following the expected path and when we may need to think differently.”