Serial determination of pulmonary function in infants with chronic lung disease

Gerhardt, Tilo; Hehre, Dorothy; Feller, Rosalyn; Reifenberg, Linda; Bancalari, Eduardo

doi:10.1016/s0022-3476(87)80516-4

Cited by 178 publications

(88 citation statements)

References 22 publications

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“…Although the Crs in infants with NCLD was consistently less than in those without, it improved considerably between 6 and 12 months. This finding is in agreement with the clinical and radiological course [11,12], and with reports on pulmonary function in NCLD infants tested at a comparable age [16][17][18][19]. In addition, a decreased compliance is also compatible with radiological and postmortem findings of widespread interstitial fibrosis with thickened airway walls combined with atelectatic and emphysematous parts of the terminal lung units [26,35,36].…”

Section: Discussionsupporting

confidence: 90%

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Pulmonary function in infants with neonatal chronic lung disease with or without hyaline membrane disease at birth

Merth¹,

Winter²,

Zonderland³

et al. 1997

Eur Respir J

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The clinical and radiological picture of bronchopulmonary dysplasia (BPD) following prolonged mechanical ventilation and administration of high concentrations of oxygen for hyaline membrane disease (HMD), described in 1967, has become relatively rare [1]. With the advent of: antenatal corticosteroids; more gentle application of mechanical ventilation; judicious administration of fluids, nutrients and oxygen; early closure of a patent ductus arteriosus; and surfactant administration, a milder form is now more prevalent [2]. The term neonatal chronic lung disease (NCLD) is currently preferred [3]. Mostly because of the increased number of surviving infants with shorter gestation [4,5], the estimated incidence of NCLD of about 30% of all ventilated newborns has not changed since the original description of BPD [6]. NCLD is now the most prevalent chronic respiratory disorder of infancy.Expectations of a decrease in the incidence of NCLD as a result of new treatments like surfactant administration to the high-risk group [7] and more sophisticated artificial ventilation [8], have not as yet been met, although new techniques are being developed to meet the challenge [9]. Moreover, a population of very small preterm babies has recently been recognized who initially have no or only mild pulmonary disease requiring no respiratory support, but subsequently develop NCLD [3,5,10], suggesting that respiratory support is not a prerequisite for developing NCLD [6,11,12].Studies published so far have described abnormal pulmonary mechanics in infants who developed NCLD following ventilatory treatment for HMD [13][14][15][16][17][18][19][20]. Abnormal respiratory function is frequently seen as a consequence of lung damage associated with the level of treatment. On the other hand, therapeutic intervention is likely to be necessary if immaturity or prematurity are associated with compromised respiratory function at birth [21]. Only one study included both ventilated and nonventilated preterm infants [17]; in that study asymptomatic infants had normal lung function by the age of 1 yr. At school age in children born prematurely, airway diameter, as inferred from forced expiratory flows, was related only to birth weight and not to the level of respiratory therapy at birth [22,23].In the present study we analysed the association between a history of HMD, difference in ventilatory support We conclude that birth weight is the major determinant of the development of neonatal chronic lung disease. At 6 and 12 months corrected age, the abnormal pulmonary function is not associated with prior hyaline membrane disease.

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Section: Discussionsupporting

confidence: 90%

“…Studies published so far have described abnormal pulmonary mechanics in infants who developed NCLD following ventilatory treatment for HMD [13][14][15][16][17][18][19][20]. Abnormal respiratory function is frequently seen as a consequence of lung damage associated with the level of treatment.…”

mentioning

confidence: 99%

Pulmonary function in infants with neonatal chronic lung disease with or without hyaline membrane disease at birth

Merth¹,

Winter²,

Zonderland³

et al. 1997

Eur Respir J

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“…In established CLDI, FRC around term equivalent is significantly reduced compared with normative data from healthy term control infants 99,100,102 or preterm controls without clinically evident neonatal pulmonary compromise. 35,58,68 During the first 2 years of life, a relative increase in FRC was observed, using gas dilution techniques.…”

Section: The Extent To Which Functional Findings Can Be Related To Pamentioning

confidence: 79%

“…35,58,68 During the first 2 years of life, a relative increase in FRC was observed, using gas dilution techniques. 99,100 Comparison of FRC pleth and FRC N2 14 in CLDI infants suggests that significant gas-trapping may occur in these infants, although the magnitude of the difference in FRC between methods needs to be interpreted cautiously, due to potential methodological limitations in the presence of marked airway obstruction.…”

Section: The Extent To Which Functional Findings Can Be Related To Pamentioning

confidence: 99%

Lung Function Tests in Neonates and Infants with Chronic Lung Disease of Infancy: Functional Residual Capacity

Hülskamp¹,

Pillow²,

Dinger³

et al. 2005

Pediatric Pulmonology

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Summary. This is the second paper in a review series that will summarize available data and discuss the potential role of lung function testing in infants and young children with acute neonatal respiratory disorders and chronic lung disease of infancy. The current paper addresses the expansive subject of measurements of lung volume using plethysmography and gas dilution/ washout techniques. Following orientation of the reader to the subject area, we focus our comments on areas of inquiry proposed in the introductory paper to this series. The quality of the published literature is reviewed critically, and recommendations are provided to guide future investigation in this field. Measurements of lung volume are important both for assessing growth and development of lungs in health and disease, and for interpreting volume-dependent lung function parameters such as respiratory compliance, resistance, forced expiratory flows, and indices of gas-mixing efficiency. Acute neonatal lung disease is characterized by severely reduced functional residual capacity (FRC), with treatments aimed at securing optimal lung recruitment. While FRC may remain reduced in established chronic lung disease of infancy, more commonly it becomes normalized or even elevated due to hyperinflation, with or without gas-trapping, secondary to airway obstruction. Ideally, accurate and reliable bedside measurements of FRC would be feasible from birth, throughout all phases of postnatal care (including assisted ventilation), and during subsequent long-term follow-up. Although lung volume measurements in extremely preterm infants were described in a research environment, resolution of several issues is required before such investigations can be translated into routine clinical monitoring. Pediatr

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“…También se ha reportado un aumento de la resistencia de las vías aéreas secundaria a la liberación de mediadores de inflamación, como leucotrienios y factor activador de plaquetas en niños con DBP 29 . Estos cambios en la mecánica pulmonar en los niños con DBP pueden ser evaluados y efectuarse su seguimiento a través de las pruebas de función pulmonar 46 .…”

Section: Aumento De Resistencia De Vías Aéreasunclassified

Actualización en Presentación y Patogénesis de la Displasia Broncopulmonar

2009

Rev. chil. pediatr.

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Update on Presentation and Pathogenesis of Brochopulmonary DysplasiaBronchopulmonary dysplasia (BPD) remains as the most frequent chronic lung disease seen among babies with very low birth weight, contributing to their morbidity and mortality. An increase in the survival of very immature babies due to improvement in pre and post natal care, has resulted in an increase in the number of newborns with BDP, although there have been no changes in the actual incidence of the disease. Objective: To describe the evolution of DBP in recent decades, the current definition, and to describe and analyze the risk factors involved in the pathogenesis of this disease. Until a few years ago, the terms BPD and chronic lung disease were used as synonyms. After the workshop sponsored by the National Institute of Health in the United States in 2001, it was recommended that the term BPD be used to describe the pulmonary sequelae of immature babies. Classic severe BPD, as described by Northway et al over forty years ago, has evolved into milder forms of chronic pulmonary damage, the so-called "new BPD", characterized by impairment of alveolarización and vascularization of the immature lung in response to multiple injuries. BPD is a multifactorial disease where major risk factors are related to pulmonary immaturity, hyperoxia, baro/volutrauma, as well as inflamation and infection. Genetic susceptibility has recently been shown to be another important risk factor. Conclusion: Bronchopulmonary Dysplasia continues to be the most frequent sequelae affecting low birth weight infants. In the past four decades, the disease has been better defined, and new pathogenetic risk factors have been established. RESUMENLa Displasia Broncopulmonar (DBP) continúa siendo la enfermedad pulmonar crónica más frecuente que afecta al recién nacido de muy bajo peso, contribuyendo a su morbilidad y mortalidad. El aumento en la sobrevida de los recién nacidos muy inmaduros, debido a la mejoría en el cuidado pre y post natal, ha aumentado el número de recién nacidos con displasia, sin cambios en su incidencia. El objetivo de esta revisión es representar los cambios en la presentación clínica de la DBP en las últimas décadas y describir ACTUALIDAD CLINICAL OVERVIEW Rev Chil Pediatr 2009; 80 (3): 213-224

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Serial determination of pulmonary function in infants with chronic lung disease

Cited by 178 publications

References 22 publications

Pulmonary function in infants with neonatal chronic lung disease with or without hyaline membrane disease at birth

Pulmonary function in infants with neonatal chronic lung disease with or without hyaline membrane disease at birth

Lung Function Tests in Neonates and Infants with Chronic Lung Disease of Infancy: Functional Residual Capacity

Actualización en Presentación y Patogénesis de la Displasia Broncopulmonar

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