Chronic lung disease of prematurity and respiratory outcome at eight years of age

Kulasekaran, Karthikeyan; Gray, Peter H.; Masters, Brent

doi:10.1111/j.1440-1754.2007.01001.x

Cited by 20 publications

(29 citation statements)

References 33 publications

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“…12,30,41,42 We found that one quarter of children born extremely preterm responded positively to pharmacological bronchodilation, implying a therapeutic way forward. 21 Nevertheless, the post bronchodilator FEV 1 was still significantly lower in the preterm group than in controls (data not shown), indicating only partially reversible airways.…”

Section: Clinical Aspects Of the Resultsmentioning

confidence: 75%

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Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

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Section: Clinical Aspects Of the Resultsmentioning

confidence: 75%

“…29 The modest or non-significant differences in lung function related to degree of BPD found by us and others indicate that childhood respiratory dysfunction can essentially be related to gestational age, and that BPD classification seems to be of limited value for predicting future lung function measured by spirometry. [30][31][32] | 69…”

Section: Discussionmentioning

confidence: 99%

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

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“…Twenty-one papers reported spirometry after a single dose of a bronchodilator [5,6,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Sixteen studies administered salbutamol, with doses ranging from 100 µg by meter-dosed inhalers to 5 mg by nebulization [5,6,8,9,10,11,12,13,16,17,20,22,23,24,25,26]: …”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two studies were included [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. Demographic details are shown in tables 1 and 2, and further details are given in the online supplementary tables E1 and E2.…”

Section: Resultsmentioning

confidence: 99%

Effect of Bronchodilators on Forced Expiratory Volume in 1 s in Preterm-Born Participants Aged 5 and Over: A Systematic Review

et al. 2015

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Background and Objectives: Preterm-born participants are at risk of long-term deficits in percentage predicted forced expiratory volume in 1 s (%FEV₁). Since it is unclear if these deficits respond to bronchodilators, we systematically reviewed the evidence for reversibility of deficits in %FEV₁ by bronchodilators in preterm-born participants. Design: Studies reporting a change in %FEV₁ in response to bronchodilator treatment in preterm-born participants at ≥5 years of age, with or without a term-born control group, were identified. The quality of studies was assessed by adapted tools. Due to considerable heterogeneity between studies, formal meta-analysis was not possible. Results: From 8,839 titles, 22 studies were identified after an updated search in May 2013. Twenty-one studies assessed the response to a single inhaled dose of a bronchodilator, and 1 study assessed longer-term effects. Most studies observed decreased %FEV₁ in preterm-born participants compared with controls. Most studies observed improved %FEV₁ after a single dose of bronchodilator, with the largest improvements noted in those with bronchopulmonary dysplasia, who had greater deficits of %FEV₁ when compared with preterm and term controls. One long-term study investigated a 2-week terbutaline administration, but the initial FEV₁ after a single dose did not show a change in %FEV₁ of ≥15%, but 5/29 (17%) children had an increased %FEV₁ of ≥10%. Conclusions: In this systematic review, disparate studies were identified. Although single doses of bronchodilators appear to improve the FEV₁ in the short term, further studies are required to assess their longer-term benefits not only on airway obstruction, but also their effect on respiratory symptoms.

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“…epithelium; airway smooth muscle; collagen; proliferation; apoptosis ADVANCES IN PERINATAL CARE have led to improved survival following very preterm birth, with infants born as early as 23-24 wk of gestation now being capable of survival and leading essentially normal lives. However, numerous studies investigating the long-term outcomes of very preterm birth have shown that children (14,17,25,27) and young adults (15) who were born preterm (Ͻ32 wk of gestation) are at an increased risk of having impaired lung function, including reductions in forced expiratory volume in 1 s (FEV 1 ) and forced expiratory flow rates (FEF 25-75% ). Together, these follow-up studies suggest that the small conducting airways may be permanently affected by very preterm birth, especially if these infants subsequently developed bronchopulmonary dysplasia (BPD).…”

mentioning

confidence: 99%

Persistent bronchiolar remodeling following brief ventilation of the very immature ovine lung

O’Reilly¹,

Hooper

Allison

et al. 2009

American Journal of Physiology-Lung Cellular and Molecular Phys

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We hypothesized that short periods of mechanical ventilation of very immature lungs can induce persistent bronchiolar remodeling that may adversely affect later lung function. Our objectives were to characterize the effects of brief, positive-pressure ventilation per se on the small airways in very immature, surfactant-deficient lungs and to determine whether the effects persist after the cessation of ventilation. Fetal sheep (0.75 of term) were mechanically ventilated in utero with room air (peak inspiratory pressure 40 cmH2O, positive end-expiratory pressure 4 cmH2O, 65 breaths/min) for 6 or 12 h, after which tissues were collected; another group was studied 7 days after 12-h ventilation. Age-matched unventilated fetuses were controls. The mean basement membrane perimeter of airways analyzed was 548.6 Ϯ 8.5 m and was not different between groups. Immediately after ventilation, 21% of airways had epithelial injury; in airways with intact epithelium, there was more airway smooth muscle (ASM) and less collagen, and the epithelium contained more mucin-containing and apoptotic cells and fewer proliferating cells. Seven days after ventilation, epithelial injury was absent but the epithelium was thicker, with greater cell turnover; there were increased amounts of bronchiolar collagen and ASM and fewer alveolar attachments. The increase in ASM was likely due to cellular hypertrophy rather than hyperplasia. We conclude that brief mechanical ventilation of the very immature lung induces remodeling of the bronchiolar epithelium and walls that lasts for at least 7 days; such changes could contribute to later airway dysfunction. epithelium; airway smooth muscle; collagen; proliferation; apoptosis ADVANCES IN PERINATAL CARE have led to improved survival following very preterm birth, with infants born as early as 23-24 wk of gestation now being capable of survival and leading essentially normal lives. However, numerous studies investigating the long-term outcomes of very preterm birth have shown that children (14,17,25,27) and young adults (15) who were born preterm (Ͻ32 wk of gestation) are at an increased risk of having impaired lung function, including reductions in forced expiratory volume in 1 s (FEV 1 ) and forced expiratory flow rates (FEF 25-75% ). Together, these follow-up studies suggest that the small conducting airways may be permanently affected by very preterm birth, especially if these infants subsequently developed bronchopulmonary dysplasia (BPD).Histological studies of the lungs of infants who were mechanically ventilated following preterm birth have shown evidence of damage to the large and small airways. In the larger airways, a loss of epithelium from the trachea and main bronchi (28) and an increased area of submucosal glands (18, 30) have been reported. Studies that have investigated the smaller airways have shown a greater amount of airway smooth muscle (ASM) (18,19,39,43), increased numbers of goblet cells and altered epithelial cells (18,43). Similar findings have been observed in animal models of v...

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Chronic lung disease of prematurity and respiratory outcome at eight years of age

Abstract: Lung function in CLD children is largely normal in comparison with preterm controls, apart from some evidence of reversible small airway obstruction. Respiratory symptomatology is not increased in chronic disease children in comparison with control preterm children.

Cited by 20 publications

References 33 publications

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Effect of Bronchodilators on Forced Expiratory Volume in 1 s in Preterm-Born Participants Aged 5 and Over: A Systematic Review

Persistent bronchiolar remodeling following brief ventilation of the very immature ovine lung

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