Not looking good

Baby girl is on high settings on NIPPV right now and is on prednisolone and lasix. Her xray of her lungs have been improving but she’s had tachypnea retractions and head bobbing recently. When she’s crying or being active it’s obvious she’s working to breathe. When she’s asleep or resting breathing looks effortless to her! She’s been diagnosed with BPD and was treated for PH a while ago. Doctors have never done any tests to look at her airway or aspirations or anything like that. We are on the verge of getting her a trach and I want to make sure I cover all my bases and exhaust other options before resulting to a major surgery like a trach. Any advice on questions I should ask or tests I should request?