Assessing Clinician Preference for Redirection of Care in Neonatal Tracheostomies

Publication Date

6-26-2026

DOI

10.31986/issn.2578.3343_vol7iss1.3

First Page

Last Page

Abstract

A spectrum of indications exists for the implementation of neonatal tracheostomies, ranging from short-term airway control to congenital airway anomalies. The decision to initiate long-term mechanical ventilation is multifaceted and can be influenced by factors such as physician preferences, caregivers’ attitudes, and comorbidities. It is important to have an ethical framework in place to guide the treatment of preterm neonates who may require long term mechanical ventilation. This study examines physician perspectives on the ethics of neonatal tracheostomy, focusing on the treatment of infants with bronchopulmonary dysplasia. A mixed methods study, consisting of demographic information and 5 clinical vignettes centering on an infant with bronchopulmonary dysplasia, was sent to physicians with experience treating bronchopulmonary dysplasia patients. The respondents chose between 3 outcomes for each scenario: keep the patient intubated with hopes of future extubation, compassionately extubate, or override parental rights with a court order. The results indicate that there are mixed feelings regarding the redirecting care for neonates with bronchopulmonary dysplasia. For 3 out of 5 of the clinical scenarios, the majority of respondents opted to keep the patient intubated with plans of future extubation. The inclusion of comorbidities such as subglottic stenosis resulted in most respondents opting to compassionately extubate the patient. Ultimately, this study highlights the complexity of the decision-making process.

Recommended Citation

DeStefano, Gabriella; Kushnir, Alla; and Donenfeld, Perri (2026) "Assessing Clinician Preference for Redirection of Care in Neonatal Tracheostomies," Cooper Rowan Medical Journal: Vol. 7: Iss. 1, Article 3.
DOI: 10.31986/issn.2578.3343_vol7iss1.3
Available at: https://rdw.rowan.edu/crjcsm/vol7/iss1/3