Pulmonary function in extremely low birth weight infants with bronchopulmonary dysplasia before hospital discharge

McEvoy, Cindy T.; Schilling, Diane; Go, Mitzi; Mehess, Shawn; Durand, Manuel

doi:10.1038/s41372-020-00856-z

Cited by 12 publications

(9 citation statements)

References 39 publications

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“…Therefore, even the distal parenchyma might be functionally affected 42 . In infants with BPD, there are fewer and larger alveoli and less airway tethering of the airways through elastic components in the alveolar wall, which can affect elastic recoil 20,45 . Therefore, it is important to study lung function in BPD in a complex way with the full spectrum of iPFT methods so as not to neglect subtle changes in the maldeveloped lung.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, infants with BPD do not need to suffer from permanently abnormal lung function 18 . Using various infant pulmonary function testing (iPFT) methods, it has been shown that lung function in infants with BPD is reduced compared to healthy term controls 19–21 . On the other hand, functional deficits similar to infants with BPD may also be found in preterm infants without the diagnosis of BPD 22–25 .…”

Section: Introductionmentioning

confidence: 99%

“…18 Using various infant pulmonary function testing (iPFT) methods, it has been shown that lung function in infants with BPD is reduced compared to healthy term controls. [19][20][21] On the other hand, functional deficits similar to infants with BPD may also be found in preterm infants without the diagnosis of BPD. [22][23][24][25] This discrepancy suggests that it is not the BPD status itself, but a combination of perinatal factors which affect lung function later in infancy.…”

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confidence: 99%

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Symptomatic preterm infants suffer from lung function deficits, regardless of bronchopulmonary dysplasia

Tuková

Koucký

Marková

et al. 2022

Pediatric Pulmonology

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Background The long‐term respiratory consequences for children with bronchopulmonary dysplasia (BPD) are well known. However, there is little emphasis on monitoring preterm infants without BPD. Few studies have explored the lung function status of infants with the symptoms of chronic lung disease of prematurity (CLD). Objective To evaluate functional lung deficits in preterm infants with CLD, and to assess the perinatal determinants of diminished lung function. Methods In our cross‐sectional study, 132 preterm infants with symptomatic CLD underwent infant pulmonary function testing (iPFT) at a median post‐term age of 0.9 years. The iPFT included bodypletysmography, compliance measurement, tidal breath analysis, and rapid thoracoabdominal compression. The relationships between the respective z scores of the iPFT parameters and perinatal characteristics, postnatal treatment, and BPD status were investigated. Results Seventy‐three patients (55.3%) were born before the 28th week of gestation, and 92 (69.7%) met the BPD criteria. Functional deficits were detected in 85.8%. The obstructive ventilatory pattern was more prevalent than restrictive (36.3 vs. 12.4%, p < 0.001). Infants with restriction had lower birth weight (BW) and required a longer duration of oxygenotherapy. In a univariate model, the lung function correlated with the duration of invasive mechanical ventilation, gestational week, and BW. In a general linear model, BPD status was not an additional determinant of the iPFT results. Conclusion IPFT may reveal significant functional deficits in preterm infants with CLD even without BPD. The current symptoms and perinatal factors may be more important determinants of functional deficits than the BPD status itself.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Symptomatic preterm infants suffer from lung function deficits, regardless of bronchopulmonary dysplasia

Tuková

Koucký

Marková

et al. 2022

Pediatric Pulmonology

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“…There have been some reports of follow-up lung function tests of BPD infants showing these children continue to have abnormal baseline spirometry with significant airway obstruction 38 , 39 . Furthermore, a previous study also reported that premature infants with BPD before hospital discharge have decreased lung function compared to healthy infants 40 .…”

Section: Discussionmentioning

confidence: 88%

Red cell distribution width as a predictor for bronchopulmonary dysplasia in premature infants

Ohto

Nollet

et al. 2021

Sci Rep

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Bronchopulmonary dysplasia (BPD) is the most common morbidity complicating preterm birth. Red blood cell distribution width (RDW), a measure of the variation red blood cell size, could reflect oxidative stress and chronic inflammation in many diseases such as cardiovascular, pulmonary, and other diseases. The objectives of the present study were to evaluate perinatal factors affecting RDW and to validate whether RDW could be a potential biomarker for BPD. A total of 176 preterm infants born at < 30 weeks were included in this study. They were categorized into BPD (n = 85) and non-BPD (n = 91) infants. RDW at birth and 14 days and 28 days of life (DOL 14, DOL 28) were measured. Clinical data were obtained from all subjects at Fukushima Medical University (Fukushima, Japan). The mean RDW at birth, DOL 14 and DOL 28 were 16.1%, 18.6%, 20.1%, respectively. Small for gestational age (SGA), chorioamnionitis (CAM), hypertensive disorders of pregnancy (HDP), gestational age and birth weight were significantly associated with RDW at birth. SGA, BPD and red blood cell (RBC) transfusion before DOL 14 were associated with RDW at DOL 14. BPD and RBC transfusion before DOL 14 were associated with RDW at DOL 28. Compared with non-BPD infants, mean RDW at birth DOL 14 (21.1% vs. 17.6%, P < 0.001) and DOL 28 (22.2% vs. 18.2%, P < 0.001) were significantly higher in BPD infants. Multivariate analysis revealed that RDW at DOL 28 was significantly higher in BPD infants (P = 0.001, odds ratio 1.63; 95% CI 1.22–2.19). Receiver operating characteristic analysis for RDW at DOL 28 in infants with and without BPD yielded an area under the curve of 0.87 (95% CI 0.78–0.91, P < 0.001). RDW at DOL 28 with mild BPD (18.3% vs. 21.2%, P < 0.001), moderate BPD (18.3% vs. 21.2%, P < 0.001), and severe BPD (18.3% vs. 23.9%, P < 0.001) were significantly higher than those with non-BPD, respectively. Furthermore, there are significant differences of RDW at DOL 28 between mild, moderate, and severe BPD. In summary, we conclude that RDW at DOL 28 could serve as a biomarker for predicting BPD and its severity. The mechanism by which RDW at DOL 28 is associated with the pathogenesis of BPD needs further elucidation.

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“…But, due to the immature lung development, many premature babies are prone to respiratory distress syndrome (RDS), apnea, pulmonary hemorrhage and other respiratory diseases, and often need mechanical ventilation [1][2][3]. Among them, because of smaller gestational age and lower birth weight, very low birth weight infants (VLBWIs) are vulnerable to pulmonary hemorrhage, which can result in respiratory failure, death and other chronic consequences [4][5].…”

Section: Introductionmentioning

confidence: 99%

Dose pulmonary hemorrhage increase the risk of bronchopulmonary dysplasia in very low birth weight infants?

Pan¹,

Tong

Wang

et al. 2022

Preprint

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Objective: To evaluate the association between pulmonary hemorrhage and bronchopulmonary dysplasia (BPD) in very low birth weight infants (VLBWIs). Methods: The study participants were all VLBW newborns admitted from January 1, 2019 to December 31, 2021. The finally included subjects were VLBWIs who survived to discharge. This study was divided into pulmonary hemorrhage group (PH group, n=33) and non-pulmonary hemorrhage group (Non-PH group, n=181). Results: By univariate analysis it was found that premature rupture of membranes, tracheal intubation in the delivery room, duration of mechanical ventilation, course of invasive ventilation (≥3 courses), pulmonary surfactant (>1 dose), medically and surgically treated patent ductus arteriosus, grade III-IV RDS, and early onset sepsis showed significant differences between groups (p<0.05). By univariate analysis, pulmonary hemorrhagedid not increase the risks of BPD and moderate to severe BPD. However, if the interference of invasive ventilation is excluded, pulmonary hemorrhage could increase the incidence of BPD (aOR=3.295, 95%CI1.183-9.179). Conclusion: Our data suggests that pulmonary hemorrhage is not associated with the development of BPD and moderate to severe BPD in VLBWIs.

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Pulmonary function in extremely low birth weight infants with bronchopulmonary dysplasia before hospital discharge

Cited by 12 publications

References 39 publications

Symptomatic preterm infants suffer from lung function deficits, regardless of bronchopulmonary dysplasia

Symptomatic preterm infants suffer from lung function deficits, regardless of bronchopulmonary dysplasia

Red cell distribution width as a predictor for bronchopulmonary dysplasia in premature infants

Dose pulmonary hemorrhage increase the risk of bronchopulmonary dysplasia in very low birth weight infants?

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