Revisiting the definition of bronchopulmonary dysplasia in premature infants at a single center quaternary neonatal intensive care unit

Kim, Faith; Bateman, David A.; Goldshtrom, Nimrod; Sahni, Rakesh; Wung, Jen Tien; Wallman-Stokes, Aaron

doi:10.1038/s41372-021-00980-4

Cited by 18 publications

(22 citation statements)

References 29 publications

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“…Use of the NIH 2018 criteria identified a greater proportion of patients than either the Shennan 1988 or NIH 2001 definitions. 35 Infants who were diagnosed BPD of any grade using the NIH 2018 criteria were more likely to develop other comorbidities than those without BPD (P<0.001) suggesting a high degree of sensitivity in predicting short term outcomes. The ability of the NIH 2018 definition of BPD to predict long term outcomes has not been assessed.…”

Section: Evaluation Of the Nih 2018 Criteriamentioning

confidence: 97%

Diagnosis and management of bronchopulmonary dysplasia

Gilfillan

Bhandari

2021

BMJ

138

103

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Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in infants and is associated with increased mortality, respiratory morbidity, neurodevelopmental impairment, and increased healthcare costs. In parallel with advances made in the field of neonatal intensive care, the phenotype of BPD has evolved from a fibrocystic disease affecting late preterm infants to one of impaired parenchymal development and dysregulated vascular growth predominantly affecting infants born before 29 weeks’ gestational age. BPD has been shown to have significant lifelong consequences. Adults with BPD have been found to have abnormal lung function tests, reduced exercise tolerance, and may be at increased risk for developing chronic obstructive pulmonary disease. Evidence shows that BPD occurs secondary to genetic-environmental interactions in an immature lung. In this review, we evaluate the various clinical definitions, imaging modalities, and biomarker data that are helpful in making an early diagnosis of BPD. In addition, we evaluate recent evidence about the prevention and treatment of BPD. We discuss the invasive and non-invasive ventilation strategies and pharmacological agents used in the early, evolving, and established phases of BPD.

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Section: Evaluation Of the Nih 2018 Criteriamentioning

confidence: 97%

Diagnosis and management of bronchopulmonary dysplasia

Gilfillan

Bhandari

2021

BMJ

138

103

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“…[26] However, the diagnostic criteria of BPD in various medical units have not been uni ed, so it is di cult to formulate a clinical application guide for early intervention of different degrees of BPD. As Faith Kim et al reported, [27] even within a single institution, the discordance between BPD incidence based on different de nitions was signi cant, highlighting the di culty in comparing BPD among centres without consistent diagnostic criteria. Therefore, it is necessary to evaluate the existing diagnostic criteria of BPD and standardize the clinical diagnosis.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Different Definitions of Bronchopulmonary Dysplasia Based on Prediction of Adverse Outcomes: Followed Up to 18-24 Months Corrected Age

Wang

et al. 2022

SSRN Journal

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“…In this retrospective cohort study, the incidence of BPD was compared before and after a significant clinical practice change of less surfactant administration and less invasive mechanical ventilation using four different definitions of BPD. In contrast to other studies that have either looked at a practice change or assessed differences in BPD incidence based on multiple definitions, our study simultaneously assessed a practice change in the context of all currently available BPD definitions [20][21][22]. Additionally, this study investigated an isolated practice change of less delivery room intubation and surfactant instillation in two consecutive time periods, in contrast to other studies that have evaluated multiple practice changes in multiple centers over time [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to other studies that have either looked at a practice change or assessed differences in BPD incidence based on multiple definitions, our study simultaneously assessed a practice change in the context of all currently available BPD definitions [20][21][22]. Additionally, this study investigated an isolated practice change of less delivery room intubation and surfactant instillation in two consecutive time periods, in contrast to other studies that have evaluated multiple practice changes in multiple centers over time [20][21][22]. This makes our research data interpretable and more generalizable in comparison to recently published studies examining similar questions.…”

Section: Discussionmentioning

confidence: 99%

Changes in Respiratory Management and the Impact on Bronchopulmonary Dysplasia

Chung

Iyengar

Santry

et al. 2021

Preprint

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Objective: Non-invasive respiratory support has reduced the need for mechanical ventilation and surfactant administration in very premature neonates. We sought to determine how the increased use of non-invasive ventilation and less surfactant instillation has impacted the development of bronchopulmonary dysplasia (BPD) and compared BPD outcome applying four currently used definitions. Study Design: This is a retrospective, single center cohort study of neonates born at less than 28 weeks gestation between 2010 and 2018. A respiratory practice change (less surfactant and more non-invasive ventilation) occurred in 2014 following participation in the SUPPORT trial. Therefore, patients were divided into 2 epochs to compare postnatal respiratory and clinical course and BPD outcomes across four currently relevant definitions (VON, NICHD, Canadian, NRN). Results: Clinical and demographic variables were similar between epochs. Despite significant differences in maternal and infant characteristics and clinical course, the incidence of BPD was not significantly different between the 2 epochs regardless of the BPD definition utilized. There was a wide range in the incidence of BPD depending on the definition used. Conclusions: Despite decreased use of invasive mechanical ventilation and surfactant administration between the two epochs, the incidence of BPD did not change and there was wide variation depending on the definition used. A better understanding of the risk factors associated with BPD and a consensus definition is urgently needed in order to facilitate the conduct of clinical trials and the development of novel therapeutic interventions to improve outcome.

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Revisiting the definition of bronchopulmonary dysplasia in premature infants at a single center quaternary neonatal intensive care unit

Cited by 18 publications

References 29 publications

Diagnosis and management of bronchopulmonary dysplasia

Diagnosis and management of bronchopulmonary dysplasia

Comparison of Different Definitions of Bronchopulmonary Dysplasia Based on Prediction of Adverse Outcomes: Followed Up to 18-24 Months Corrected Age

Changes in Respiratory Management and the Impact on Bronchopulmonary Dysplasia

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