Bronchopulmonary dysplasia prediction model for 7-day-old infants

Bhering, Carlos Alberto; Mochdece, Christieny Chaipp; Moreira, Maria Elizabeth Lopes; Rocco, José Rodolfo; Sant’Anna, Guilherme M.

doi:10.2223/jped.1599

Cited by 17 publications

(20 citation statements)

References 12 publications

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“…The human lung undergoes maturation during five stages, each of which has distinct growth milestones at specific gestational periods [9]. The latter two stages extend from 26-28 to 32-36 weeks gestation [7,[12][13][14][15].…”

Section: Dysplasiamentioning

confidence: 99%

Definition and Outpatient Management of the Very Low-Birth-Weight Infant With Bronchopulmonary Dysplasia

Groothuis¹,

Makari²

2012

Adv Therapy

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Section: Dysplasiamentioning

confidence: 99%

Definition and Outpatient Management of the Very Low-Birth-Weight Infant With Bronchopulmonary Dysplasia

Groothuis¹,

Makari²

2012

Adv Therapy

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“…Clinicians, parents, and researchers would benefit from an accurate predictive model of BPD risk based on readily available clinical information. Previous predictive models of BPD risk have been reported (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Although sometimes used in research (15), none are currently used in common clinical practice for a variety of reasons (e.g., the populations were from the presurfactant era or before widespread use of antenatal steroids, BPD was defined as a dichotomous variable at a postnatal age of limited relevance [28 d], or death was not included in all models as a competing outcome for BPD).…”

mentioning

confidence: 99%

“…An additional problem with previously reported analyses is a lack of detail regarding the change in BPD risk with advancing postnatal age (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Traditionally, researchers identified risk factors for BPD by categorizing premature infants as having or not having BPD at 28 postnatal days or 36 weeks postmenstrual age, and then examining all factors that influenced risk up to the time of diagnosis.…”

mentioning

confidence: 99%

Prediction of Bronchopulmonary Dysplasia by Postnatal Age in Extremely Premature Infants

Laughon¹,

Langer

Bose³

et al. 2011

Am J Respir Crit Care Med

362

327

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Rationale: Benefits of identifying risk factors for bronchopulmonary dysplasia in extremely premature infants include providing prognostic information, identifying infants likely to benefit from preventive strategies, and stratifying infants for clinical trial enrollment. Objectives: To identify risk factors for bronchopulmonary dysplasia, and the competing outcome of death, by postnatal day; to identify which risk factors improve prediction; and to develop a Web-based estimator using readily available clinical information to predict risk of bronchopulmonary dysplasia or death. Measurements and Main Results: Bronchopulmonary dysplasia was defined as a categorical variable (none, mild, moderate, or severe). We developed and validated models for bronchopulmonary dysplasia risk at six postnatal ages using gestational age, birth weight, race and ethnicity, sex, respiratory support, and FI O 2 , and examined the models using a C statistic (area under the curve). A total of 3,636 infants were eligible for this study. Prediction improved with advancing postnatal age, increasing from a C statistic of 0.793 on Day 1 to a maximum of 0.854 on Day 28. On Postnatal Days 1 and 3, gestational age best improved outcome prediction; on Postnatal Days 7, 14, 21, and 28, type of respiratory support did so. A Web-based model providing predicted estimates for bronchopulmonary dysplasia by postnatal day is available at https://neonatal.rti.org. Conclusions: The probability of bronchopulmonary dysplasia in extremely premature infants can be determined accurately using a limited amount of readily available clinical information.Keywords: bronchopulmonary dysplasia; prematurity; low-birth-weight infant AT A GLANCE COMMENTARY Scientific Knowledge on the SubjectBronchopulmonary dysplasia is the most common serious pulmonary morbidity in premature infants. Although accurate predictive models of bronchopulmonary dysplasia risk are sometimes used in research, none are currently used in common clinical practice for a variety of reasons. What This Study Adds to the FieldIn this study, we identified the change in the relative contributions of a variety of risk factors to the prediction of bronchopulmonary dysplasia with advancing postnatal age. This tool may help identify patients most likely to benefit from postnatal treatment and assist in the design of clinical trials to assess the efficacy of preventive therapies in high-risk populations.

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“…1 No Brasil, em pesquisas recentes a incidência variou entre 21% a 68%. [3][4][5][6][7] Em Pernambuco, uma pesquisa realizada em maternidade de referência, a incidência de DBP foi 17,6 % entre recém-nascidos prematuros e com muito baixo peso. 8 Esta variação pode ser atribuída a heterogeneidade das populações e dos cuidados aos neonatos 9 além das diferentes definições utilizadas para a doença entre os estudos.…”

Section: Introductionunclassified

Fatores associados à displasia broncopulmonar em prematuros sob ventilação mecânica precoce

Duarte

Coutinho

2012

Rev. Bras. Saude Mater. Infant.

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OBJETIVOS: descrever os fatores neonatais e de assistência ventilatória associados à displasia broncopulmonar (DBP), e verificar sua frequência em recém-nascidos prematuros submetidos à ventilação mecânica (VM) na primeira semana de vida. MÉTODOS: coorte retrospectiva, realizada em Unidade de Terapia Intensiva Neonatal. Foram analisados prontuários de 86 prematuros, sob VM na primeira semana de vida e registrados dados neonatais, parâmetros da VM e sua relação com a DBP. Para verificar a associação entre as variáveis do estudo e a DBP utilizou-se o teste do qui-quadrado e o Exato de Fisher quando indicado. O teste t e o Kruskal Wallis foram utilizados para a comparação das médias das variáveis contínuas. RESULTADOS: a DBP ocorreu em 17,4%. Foram relacionados à doença: menor peso ao nascer e idade gestacional, Apgar <7 no 1º e 5º minutos, maior tempo sob antibioticoterapia, nutrição parenteral e VM, valores elevados de fração inspirada de oxigênio (FiO2), VM como primeiro suporte respiratório, menor volume de nutrição enteral e ganho ponderal . Não houve diferença nos níveis de pressão positiva inspiratória, pressão positiva expiratória final e diferença de pressão. CONCLUSÕES: a ocorrência da DBP foi baixa e relacionada ao manejo clínico e nutricional e VM precoce e prolongada. Excetuando-se a FiO2 média não foi encontrada relação entre a doença e os demais parâmetros ventilatórios.

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Bronchopulmonary dysplasia prediction model for 7-day-old infants

Cited by 17 publications

References 12 publications

Definition and Outpatient Management of the Very Low-Birth-Weight Infant With Bronchopulmonary Dysplasia

Definition and Outpatient Management of the Very Low-Birth-Weight Infant With Bronchopulmonary Dysplasia

Prediction of Bronchopulmonary Dysplasia by Postnatal Age in Extremely Premature Infants

Fatores associados à displasia broncopulmonar em prematuros sob ventilação mecânica precoce

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