Prediction of outcome from the chest radiograph appearance on day 7 of very prematurely born infants

Greenough, Anne; Thomas, Mark R.; Dimitriou, Gabriel; Williams, Olivia; Johnson, Alice; Limb, Elizabeth; Peacock, Janet L.; Marlow, Neil; Calvert, Sandy

doi:10.1007/s00431-003-1332-6

Cited by 13 publications

(22 citation statements)

References 12 publications

(18 reference statements)

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“…29 The same group later reported that CXR appearance on postnatal day 7 facilitates prediction of outcome of infants born very prematurely. 30 Chest x-rays however have significant limitations in the evaluation of children with BPD as there is a poor correlation between chest x-ray appearance and clinical status. 31 …”

Section: Biomarkersmentioning

confidence: 99%

Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia

Lal

Ambalavanan

2015

Clinics in Perinatology

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Bronchopulmonary Dysplasia (BPD) continues to be an important source of morbidity and mortality in premature neonates. The phenotype of BPD is extremely variable, and diagnosis is a clinical operational definition. A number of clinical and laboratory biomarkers have been proposed for the early identification of infants at higher risk of this disease, to characterize disease activity and severity and for determination of prognosis. Clinical prediction models for BPD have been developed using birth weight, gestational age, indicators of respiratory illness severity, and other clinical variables. Other biomarkers of BPD include those based on imaging of the lungs, lung function measures, and measurements of various analytes in different body fluids (blood, tracheal aspirates, exhaled breath condensates, urine, etc). Novel systems biology ‘omic’ based approaches including but not limited to genomics, proteomics, metabolomics and microbiomics are required for evaluating the multiple interacting cellular and molecular networks that control lung development and injury in BPD. Here we present a critical evaluation of the biomarker approaches studied in the diagnosis of BPD and highlight the future avenues for research in this field.

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Section: Biomarkersmentioning

confidence: 99%

Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia

Lal

Ambalavanan

2015

Clinics in Perinatology

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“…Some are too complex to be used in routine clinical practice, but one system scoring only the degree of hyperinflation and the presence of interstitial shadows/fibrosis and cysts has been produced. This scoring system has been demonstrated to predict BPD development when applied to chest radiographs taken on day seven [50] and troublesome wheeze at follow-up when applied to the chest radiographs taken at 36 weeks post-menstrual age [51]. The results of lung function measurements have also been used as predictors; infants who develop BPD being shown to have a raised respiratory resistance, a low compliance and/or a low functional residual capacity (FRC).…”

Section: Prediction Of Bpdmentioning

confidence: 97%

Prevention of Bronchopulmonary Dysplasia

Greenough¹

2005

CPR

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Bronchopulmonary dysplasia (BPD) is a common outcome of very premature birth. Affected infants are chronically oxygen dependent, require frequent hospital readmission and have troublesome respiratory symptoms and lung function abnormalities even at school age. BPD has a multifactorial aetiology and many preventative strategies have been assessed. Unfortunately, results of randomised trials have demonstrated that neither antenatal administration of corticosteroids or TRH nor postnatal surfactant administration prevents BPD. Similarly randomised comparisons of various respiratory modes have failed to identify one with a lower incidence of BPD. Fluid overload increases the likelihood of a patent ductus arteriosus and hence BPD, but neither fluid restriction nor diuresis promoting agents prevent BPD. Preliminary evidence suggests that inhaled nitric oxide given prophylactically might be efficacious. The only effective preventative strategy identified by large randomised trials is systemic administration of corticosteroids in the first two weeks after birth, unfortunately this treatment may also increase adverse neurodevelopmental outcome. It is, therefore, crucial to find a corticosteroid regime with a positive risk benefit ratio or preferably a safer and more effective treatment. In addition, it is important to develop a tool to accurately identify infants predestined to develop BPD, enabling them to be targeted for preventative strategies.

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“…Chest X-rays taken before the sixth day were excluded as the radiographic pattern of resolving RDS cannot be distinguished from LLS. Fifty-nine (72%) infants had at least one chest radiograph taken after the fifth day, and the median number of radiographs available per infant was 5 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Of the 368 available radiographs, 316 were taken between 6 days' chronological age and 40 weeks' PMA and 148 at the diagnostic time points, namely the 5th-15th day, 28th (21st-35th) day, 36 (35-37) weeks PMA and term (37-43 weeks PMA).…”

Section: Chest Radiographsmentioning

confidence: 99%

“…However, at present they are not available for routine evaluation in the neonatal period (see for review [26]). Chest radiographs continue to be routinely obtained in symptomatic patients and may give information on the pulmonary status earlier than some other criteria [2,6,14]. The purpose of this study was to evaluate the occurrence and clinical correlates of the two radiographic patterns of BPD by term age in a cohort of VLBW infants.…”

Section: Introductionmentioning

confidence: 99%

Frequency and clinical correlates of radiographic patterns of bronchopulmonary dysplasia in very low birth weight infants by term age

et al. 2011

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Prediction of outcome from the chest radiograph appearance on day 7 of very prematurely born infants

Abstract: In infants who require a chest radiograph for clinical purposes at 7 days, the chest radiograph appearance can facilitate prediction of outcome of infants born very prematurely.

Cited by 13 publications

References 12 publications

Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia

Biomarkers, Early Diagnosis, and Clinical Predictors of Bronchopulmonary Dysplasia

Prevention of Bronchopulmonary Dysplasia

Frequency and clinical correlates of radiographic patterns of bronchopulmonary dysplasia in very low birth weight infants by term age

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