Longitudinal impairment of lung function in school‐age children with extremely low birth weights

Hirata, Katsuya; Nishihara, Masahiro; Kimura, Takeshi; Shiraishi, Jun; Hirano, Shinya; Kohno, Hiroyuki; Fujimura, Masanori

doi:10.1002/ppul.23669

Cited by 38 publications

(29 citation statements)

References 40 publications

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“…27 Similarly, in ELBW children the obstructive pattern of lung function deteriorated between 8 and 12 years. 28 A possible explanation for our results is that exposure of the immature lung to the shear stress of mechanical ventilation and/or the higher inspired oxygen concentration compared to in utero may have affected subsequent airway development. Cyclic stretching of isolated lung cells results in production of IL-8 and other inflammatory markers and the magnitude of production was related to the degree of stretch.…”

Section: Discussionmentioning

confidence: 89%

“…Importantly, those who were smokers at 18 years had airway obstruction that increased over time compared with those who did not . Similarly, in ELBW children the obstructive pattern of lung function deteriorated between 8 and 12 years …”

Section: Discussionmentioning

confidence: 96%

“…In contrast, among young people born very low birth weight (VLBW) who developed BPD, airway obstruction worsened between 8 and 18 years . In addition, among 87 extremely low birth weight (ELBW) survivors lung function significantly deteriorated between 8 and 12 years (FEV 1 from 83% to 77% expressed as the percent predicted for age, height and sex and FEV 1 /FVC from 84% to 78%); the deterioration was independent of the diagnosis of BPD . Whether there are changes in lung function during childhood in those born extremely prematurely and routinely exposed to antenatal corticosteroids and postnatal surfactant remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal assessment of lung function in extremely prematurely born children

Zivanovic

Lunt

et al. 2018

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Longitudinal assessment of lung function in extremely prematurely born children

Zivanovic

Lunt

et al. 2018

Pediatric Pulmonology

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“…Bronchopulmonary dysplasia (BPD) is the most common cause of chronic lung disease in children born prematurely, with recent reports indicating an increase in its incidence, mainly in low‐ and middle‐income countries (LMICs) . When compared to patients without BPD, premature infants with BPD have significantly higher rates of respiratory problems at follow‐up, including respiratory symptoms, chronic respiratory morbidity, impairment of lung function, and recurrent wheezing and other asthma symptoms, often leading to a need for respiratory medications and increased healthcare utilization, including hospitalizations for acute lower respiratory infections (ALRIs) . Although ALRIs pose a significant health problem in high‐income countries, they are an even greater problem in LMICs and are considered to be the leading cause of death among infants and children living in these countries .…”

Section: Introductionmentioning

confidence: 99%

Predictors of prolonged length of hospital stay or readmissions for acute viral lower respiratory tract infections among infants with a history of bronchopulmonary dysplasia

Rodríguez‐Martínez

Acuña‐Cordero

Sossa-Briceño

2017

Journal of Medical Virology

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Length of hospital stay and readmissions are outcome measures that have been largely overlooked in many studies that have evaluated the clinical evolution of pediatric patients with bronchopulmonary dysplasia (BPD). The aim of the present study was to identify predictors of prolonged hospitalizations or readmissions for acute lower respiratory infections (ALRIs) in infants with BPD. In a prospective cohort study, we determined independent predictors of prolonged hospitalizations or readmissions for ALRIs during the first 2 years of life in a population of infants with BPD living in Bogota, Colombia. Of a total of 138 patients included in the study, 83 (60.1%) had at least one hospitalization for ALRI during the follow-up period. After controlling for potential confounders, we found that independent predictors of prolonged hospitalizations or readmissions for ALRIs included male gender (OR = 3.09; CI 95% 1.27-7.52; P = 0.013), ambulatory oxygen therapy between 90 and 119 days (OR = 3.21; CI 95% 1.00-10.24; P = 0.049), ambulatory oxygen therapy equal to or greater than 120 days (OR = 5.73; CI 95% 2.01-16.32; P = 0.001), gestational age at birth (OR = 1.35; CI 95% 1.03-1.76; P = 0.026), birth weight (OR = 0.997; CI 95% 0.996-0.999; P = 0.010), and duration of breastfeeding equal to or greater than 6 months (OR = 0.39; CI 95% 0.16-0.96; P = 0.039). The factors identified can be taken into account when planning policies to reduce duration of hospital stay and readmissions in infants with BPD.

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“…An impaired lung function has been identified in both "old" and "new" BPD survivors, and it is associated with more respiratory symptoms and abnormal chest imaging findings [152]. In addition, a deterioration of lung function during childhood and adolescence has been described in longitudinal studies of preterm and BPD survivors [153][154][155].…”

Section: Long-term Pulmonary Outcomementioning

confidence: 99%

Present and Future of Bronchopulmonary Dysplasia

Bonadies

Zaramella

Porzionato

et al. 2020

JCM

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Bronchopulmonary dysplasia (BPD) is the most common respiratory disorder among infants born extremely preterm. The pathogenesis of BPD involves multiple prenatal and postnatal mechanisms affecting the development of a very immature lung. Their combined effects alter the lung’s morphogenesis, disrupt capillary gas exchange in the alveoli, and lead to the pathological and clinical features of BPD. The disorder is ultimately the result of an aberrant repair response to antenatal and postnatal injuries to the developing lungs. Neonatology has made huge advances in dealing with conditions related to prematurity, but efforts to prevent and treat BPD have so far been only partially effective. Seeing that BPD appears to have a role in the early origin of chronic obstructive pulmonary disease, its prevention is pivotal also in long-term respiratory outcome of these patients. There is currently some evidence to support the use of antenatal glucocorticoids, surfactant therapy, protective noninvasive ventilation, targeted saturations, early caffeine treatment, vitamin A, and fluid restriction, but none of the existing strategies have had any significant impact in reducing the burden of BPD. New areas of research are raising novel therapeutic prospects, however. For instance, early topical (intratracheal or nebulized) steroids seem promising: they might help to limit BPD development without the side effects of systemic steroids. Evidence in favor of stem cell therapy has emerged from several preclinical trials, and from a couple of studies in humans. Mesenchymal stromal/stem cells (MSCs) have revealed a reparatory capability, preventing the progression of BPD in animal models. Administering MSC-conditioned media containing extracellular vesicles (EVs) have also demonstrated a preventive action, without the potential risks associated with unwanted engraftment or the adverse effects of administering cells. In this paper, we explore these emerging treatments and take a look at the revolutionary changes in BPD and neonatology on the horizon.

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Longitudinal impairment of lung function in school‐age children with extremely low birth weights

Abstract: In ELBW survivors, the obstructive pattern of lung function impairment deteriorated from 8 to 12 years of age, independent of the presence of severe BPD or bubbly/cystic appearance in the neonatal period.

Cited by 38 publications

References 40 publications

Longitudinal assessment of lung function in extremely prematurely born children

Longitudinal assessment of lung function in extremely prematurely born children

Predictors of prolonged length of hospital stay or readmissions for acute viral lower respiratory tract infections among infants with a history of bronchopulmonary dysplasia

Present and Future of Bronchopulmonary Dysplasia

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