Behavioral Signs of Respiratory Instability: The Development and Administration of a Scale to Monitor Signs of Respiratory Distress During Developmental Interventions in Infants With Bronchopulmonary Dysplasia

Neurodevelopmental outcomes in children with bronchopulmonary dysplasia continue to be below average, even when compared with their Extremely Low Birth Weight peers. A 10-point scale that measures Behavioral Signs of Respiratory Instability (BSRI) was created to give the examiner objective information regarding a patient's tolerance to developmentally appropriate activities. The scale has not yet been validated but was being used to determine if the measures would be an accurate representation of the therapists' subjective reports before standardization. This report outlines application and use of the BSRI with two bronchopulmonary dysplasia patients during their inpatient stay. It demonstrates both a favorable and undesirable response to oxygen weaning when comparing the total BSRI score to the patients daily oxygen requirement. This information provided the medical team at the Nationwide Children's Hospital Neonatal Intensive Care Unit with a more complete clinical picture than that obtained from routine physiological variables. It is the developers' hope that the scale ultimately has the potential to improve neurodevelopmental outcomes.