Spectrum of chronic lung disease in a population of newborns with extremely low gestational age

Abstract

Difficulty in oxygenation was a general observation in ELGANs and not only a particular subset. Gestational age and Apgar score were independent predictors of the degree of difficulty over the first month of life. As oxygenation failure often developed after a few days, the process may be possible to treat or prevent once the pathogenesis is known.

Persisting hypoxaemia is an insufficient measure of adverse lung function in very immature infants

“…Although it often does not start in the first days of life, hypoxaemia is a predominant sign in the first period of extrauterine life in very immature infants 12 26. The mechanisms involved are remarkably little investigated.…”

“…The average of weekly measurements of the alveolar-arterial difference of oxygen tension (AaDO 2 ) over the first month of life was calculated 12. We used AaDO 2 at 36 weeks PMA as a measure of oxygenation difficulty at that age.…”

“…The time from birth until oxygen supplementation was permanently withdrawn was used to assess the duration of hypoxaemia. AaDO 2 was assessed by measuring the inspired oxygen fraction together with arterial oxygen and carbon dioxide tensions, by sampling arterial blood or by the transcutaneous route,13 and assuming that the respiratory quotient was 1 12 14…”

Adult Respiratory Outcomes of Extreme Preterm Birth. A Regional Cohort Study

“…In 2012, Bancalari and Jobe recently proposed a new diagnostic term to better describe the clinical course followed by many of today's EPB NICU dwellers; respiratory instability of prematurity 144 . They were challenged among others by Hjalmarson and Sandberg 60 , arguing that lung disease in EPB reflects continuous and not dichotomous features, with no clear tendency for 'healthy' and 'diseased' subgroups 125,145 .…”

Comparisons and Limitations of Current Definitions of Bronchopulmonary Dysplasia for the Prematurity and Respiratory Outcomes Program

“…The pathophysiology of BPD is complex and may differ substantially between infants with different antenatal and early postnatal exposures (5). Almost all very low birth weight infants, even those with normal saturations in room air, have abnormal pulmonary function at 36 weeks (6). Conversely, pulmonary-related deaths before 36 weeks are not captured by current definitions of BPD (7,8) and remain a frequent cause of mortality in extremely premature infants (9).…”