Summary Speculation MATERIALS AND METHODSSevere neonatal lung injury, with persistent oxygen dependency throughout infancy might result in inhibition or marked slowing of lung growth. Because development of conducting airways is completed early during intrauterine life and because most alveolar development takes place postnatally, one might expect disturbances in alveolar growth to overshadow residual airway injury in survivors of bronchopulmonary dysplasia.Morphometric analysis of the lungs and heart of a male infant who died at 33 months of age of bronchopulmonary dysplasia after prematurity and respiratory distress syndrome and its treatment is presented. Alveolar internal surface area was 8.4 m 2 compared to 15.3-27.8 for age-matched controls. The number of alveoli was 19 X 10 6 (123.3-172.5 X 10 6 for controls); however, the mean small airway diameter, 0.44 mm was normal, and small airway abnormalities were minimal. There was marked muscular hypertrophy of the right ventricle.The growth and development of the lungs follow a continuous course, beginning with conception and finishing when somatic growth ceases. Conducting airways are fully formed by the sixteenth wk of gestational age, whereas multiplication of alveoli continues throughout gestation, infancy, and early childhood (21).In the premature infants with mild hyaline membrane disease, pulmonary function tests after the first year of life seem to indicate that such infants subsequently progress toward normal lung development (4, II,19,23). On the other hand, little is known of the nature and degree of "catch-Up" lung growth during early childhood in premature infants who are survivors of severe respiratory distress syndrome and its sequel, bronchopulmonary dysplasia (BPO). In this group of older infants with BPO, pulmonary function studies during the first year of life (4, 19) have shown marked abnormalities, including hypoxemia, increased lung volume, maldistribution of ventilation, and increased airway resistance. These findings have been attributed mostly to the presence of interstitial edema (13, 22) and/or increased bronchiolar secretions (3, 18). Obliterative airway disease and simplified alveoli with interstitial fibrosis have been described in infants with BPO,(3,16,18), but, to our knowledge, quantitative anatomic studies have not been done. required continuous positive airway pressure (CPAP) with 100% oxygen mask-bag because of bradycardia and cyanosis. He was admitted to the intensive care nursery and had a gestational age of 31 wk by Oubowitz criteria (weight, 1500 g; length, 41 cm; and head circumference, 27.5 cm). Despite CPAP and 100% inspired oxygen the child developed immediate and severe respiratory distress with apneic spells. At 35 min of age he was intubated and mechanically ventilated with an inspired oxygen concentration (FI02) of 80% and positive end-expiratory pressure (PEEP) of 8 cm H20. The peak pressure remained between 40-50 cm of H 2 0 during the first wk; the oxygen requirement diminished rapidly to 60% at 12 hand 40% at...
Pulmonary function tests (PFT) were obtained during the course of a self-controlled study of six children aged 5 to 43 months who had moderate to severe bronchopulmonary dysplasia (BPD). Changes after the administration of intravenous (IV) furosemide (2 mg/kg), inhaled isoproterenol (0.2 cc, 1:200), inhaled atropine sulfate (0.05 mg/kg), and a placebo were assessed. The study indicated the furosemide and atropine significantly (P less than 0.05) increased dynamic compliance (CL) for the group. A decrease in total pulmonary resistance (RL) and work of breathing (W) was observed after isoproterenol, although the responses were not significant (P = 0.08 and P = 0.09, respectively). It was speculated that pulmonary edema and increased vagal tone may contribute to small airway dysfunction in children who have BPD.
Spine deformity and chronic pulmonary disease are commonly seen in patients with cystic fibrosis (CF). In order to assess the prevalence of kyphosis, a retrospective evaluation of all initial standing chest radiographs of our CF patients matched with our "reference" population was undertaken. We also studied the possible correlation between the degree of kyphosis and the pulmonary function tests ( PFTs ), consisting of thoracic gas volume and maximal expiratory flows. In our population, the study confirmed an increased prevalence of kyphosis in CF patients (p less than .01), which occurred mostly in girls after 12 years of age (p less than .018). The kyphosis appeared to be, in most instances, of mild degree and was not related to any of the PFTs . No measurable increase of kyphosis was observed over a 3-year period in the group. Longer prospective study and the relationship of kyphosis to endocrine function in CF at puberty should be undertaken.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.