Decreasing early invasive mechanical ventilation exposure in preterm infants: a quality improvement initiative

Objective: To decrease invasive mechanical ventilation exposure in the neonatal intensive care unit (NICU) in the first week of life for preterm infants with the global aim of decreasing bronchopulmonary dysplasia (BPD).

Methods: We created a quality improvement (QI) initiative to optimize early non-invasive respiratory support which launched in August 2021. Patients born at <32 weeks gestation and admitted to the NICU on non-invasive respiratory support were included.

Results: Invasive mechanical ventilation exposure decreased from 38 to 25% with evidence of special cause variation beginning in August 2022. Infants born at ≥26 weeks were most impacted, with a 50% reduction, from 34 to 17%. While BPD rates decreased, there has not yet been evidence of special cause variation.

Conclusion: Invasive mechanical ventilation exposure for infants born at <32 weeks gestation decreased following the creation of a QI initiative focused on optimization and standardization of early non-invasive respiratory support.