Designing a better definition of bronchopulmonary dysplasia

Bhandari, Vineet

doi:10.1002/ppul.24305

Cited by 9 publications

(6 citation statements)

References 26 publications

(28 reference statements)

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“…1,25 The physiologic definition of BPD further refined this definition and recently several new definitions are under discussion that still need to be validated. 13,22,26,27 Jensen et al have proposed 18 revised pragmatic definitions of BPD using a data-driven approach to better predict childhood morbidity. They identified an optimal definition of BPD that demonstrated a c-statistic of 0.785 (sensitivity 36%, specificity 96%) and 0.747 (sensitivity 69%, specificity 68%) for predicting adverse respiratory and neurodevelopmental outcomes, respectively.…”

Section: Discussionmentioning

confidence: 99%

Early prediction of moderate to severe bronchopulmonary dysplasia in extremely premature infants

Sharma

Xin

Chen

et al. 2020

Pediatrics & Neonatology

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Background: Bronchopulmonary Dysplasia (BPD) is the commonest morbidity in extremely preterm infants (PTIs). Risk factors for BPD have been described in the era before the widespread availability of non-invasive ventilation (NIV) in the delivery room (DR). The objective of this study is to identify risk factors for Moderate/Severe BPD in an era of widespread availability of NIV in the DR. Methods: Detailed antenatal and postnatal data were abstracted for PTIs, 23 0/7 e27 6/7 weeks GA. Multivariate logistic regression and classification and regression tree analyses (CART) identified predictors for the primary outcome of Moderate/Severe BPD. Results: Of 263 eligible infants, 59% had Moderate/Severe BPD. Moderate/Severe BPD was significantly associated with birthweight, gender, DR intubation and surfactant compared to No/Mild BPD. Of infants not intubated in the DR, 40% with No/Mild BPD and 80% with Moderate/Severe BPD received intubation by 48 hours (p < 0.05). Infants with Moderate/Severe BPD received longer duration of oxygen and mechanical (MV). On logistic regression, birthweight, gender, oxygen concentration, cumulative duration of oxygen and MV, surfactant, and blood transfusions predicted Moderate/Severe BPD. Both CART analysis and logistic regression showed duration of oxygen and MV to be the most important predictors for Moderate/Severe BPD. Conclusions: In an era of increasing availability of NIV in the DR, lower birthweight, male gender, surfactant treatment, blood transfusions and respiratory support in the first 2e3 weeks after birth predict Moderate/Severe BPD with high sensitivity and specificity. The majority of

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Section: Discussionmentioning

confidence: 99%

Early prediction of moderate to severe bronchopulmonary dysplasia in extremely premature infants

Sharma

Xin

Chen

et al. 2020

Pediatrics & Neonatology

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“…BPD severity was defined according to the National Heart, Lung, and Blood Institute (NHLBI) (5). Severity was also defined based on oxygen requirements at 36 weeks postmenstrual age or at discharge in the following manner: If no supplemental oxygen was required it was classified as mild, if oxygen requirements were less than 0.3 FiO2 it was considered as moderate, and if the requirements were greater than 0.3 FiO2 or if there was a need of some type of ventilator support (invasive, noninvasive), it was considered severe (5,6). Oxygen requirement is defined as when the patient presents saturation values for hemoglobin pulse oximetry below 90% at sea level.…”

Section: Methodsmentioning

confidence: 99%

Bronchopulmonary dysplasia: incidence and severity in premature infants born at high altitude.

Rodriguez

Ramieez²,

Benjumea³

2021

Preprint

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Background: Bronchopulmonary dysplasia (BPD) is the most common cause of chronic lung disease in children born prematurely. There is little information about the epidemiology and severity of BPD places with high altitude. This study aimed to evaluate the frequency of BPD severity levels and the associated risk factors with severity in a cohort of preterm newborns ≤34 weeks of gestational age born in Rionegro, Colombia Materials and methods: We carried out a retrospective analytical cohort of preterm newborns without major malformations from Rionegro, Colombia between 2011-2018 admitted to neonatal intensive unit at high altitude (2200m above sea level). The main outcomes were the incidence and severity of bronchopulmonary dysplasia. Results: The bronchopulmonary dysplasia incidence was 25.7% (95% CI, 21.6-29.9). Bronchopulmonary dysplasia was moderate in 62.1% of patients and severe in 26.7%. After modeling regression analysis, the final variables associated with BPD severity levels were: sepsis (OR 2.37 CI 95% 1.04-5.40) and pulmonary hypertension (OR 3.79 CI95% 1.19-12). Conclusion: The incidence of BPD was higher and similar to cities with higher altitudes. In our population, the variables associated with BPD severity levels were: duration of oxygen therapy and pulmonary hypertension. It is necessary to increase the awareness of risk factors, the effect of clinical practices, and early recognition of bronchopulmonary dysplasia to reduce morbidity in patients with this pathology.

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“…Hyperoxia and barotrauma associated with neonatal mechanical ventilation have been linked to long‐lasting complications that persist in the adult lung, such as pulmonary or systemic hypertension and pulmonary vascular disease 1,4–6 . While the commonly accepted clinical definition of moderate‐to‐severe BPD requires supplemental oxygen for a minimum of 28 days and respiratory support at 36 weeks postmenstrual age (PMA), this definition has been challenged 1,2,4,7–10 . In addition, histological evidence of BPD has been detected in postmortem lung samples of infants as early as 6 days of life, 11 suggesting that the inception of BPD begins earlier than the clinical definition allows.…”

Section: Introductionmentioning

confidence: 99%

MicroRNA dysregulation in the heart and lung of infants with bronchopulmonary dysplasia

Koussa

Dombkowski

Cukovic

et al. 2023

Pediatric Pulmonology

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Background and Objectives Bronchopulmonary dysplasia (BPD) is a serious complication of preterm birth, resulting in significant morbidity and mortality. Recent studies have suggested that microRNA (miRNA) dysregulation is involved in the pathogenesis of BPD and may serve as biomarkers for early detection. We conducted a directed search for dysregulated miRNAs in lung and heart autopsy samples of infants with histologic BPD. Methods We used archived lung and heart samples from BPD (13 lung, 6 heart) and control (24 lung, 5 heart) subjects. To measure miRNA expression, RNA was extracted from formalin‐fixed, paraffin‐embedded (FFPE) tissue specimens then reverse‐transcribed, labeled, and hybridized to miRNA microarrays. The microarrays were scanned, and data were quantile normalized. Statistical analysis with a moderated t‐test and control of the false discovery rate (5%) was used to compare normalized miRNA expression values between clinical categories. Results With our set of 48 samples, 43 miRNAs had a significant difference in expression comparing BPD to non‐BPD controls. Among the most statistically significant miRNAs, miR‐378b, miRNA‐184, miRNA‐3667‐5p, miRNA‐3976, miRNA‐4646‐5p, and miRNA‐7846‐3p were all consistently upregulated in both the heart and lung tissues of BPD subjects. The cellular pathway predicted to be most affected by these miRNAs is the Hippo signaling pathway. Conclusions This study identifies miRNAs that are similarly dysregulated in postmortem lung and heart samples in subjects with histologic BPD. These miRNAs may contribute to the pathogenesis of BPD, have potential as biomarkers, and may provide insight to novel approaches for diagnosis and treatment.

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Designing a better definition of bronchopulmonary dysplasia

Cited by 9 publications

References 26 publications

Early prediction of moderate to severe bronchopulmonary dysplasia in extremely premature infants

Early prediction of moderate to severe bronchopulmonary dysplasia in extremely premature infants

Bronchopulmonary dysplasia: incidence and severity in premature infants born at high altitude.

MicroRNA dysregulation in the heart and lung of infants with bronchopulmonary dysplasia

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