Structural and Functional Lung Impairment in Adult Survivors of Bronchopulmonary Dysplasia

Caskey, S.; Gough, Aisling; Rowan, Stephen; Gillespie, Scott; Clarke, J.; Riley, M.; Megarry, J; Nicholls, Paul; Patterson, Chris; Halliday, Henry L.; Shields, Michael; McGarvey, Lorcan

doi:10.1513/annalsats.201509-578oc

Cited by 106 publications

(128 citation statements)

References 32 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…The most characteristic finding was linear or triangular subpleural opacities that were present in 15 (71%) of the scans. This is in line with previous reports on survivors treated either before [2,3,4,5,6,7,21,22] or after [8,23,24] the introduction of surfactants and antenatal steroids as common treatment practices (Table 4). The subpleural opacities may correspond to the strands of atelectasis that extend to the pleura (linear opacities) and create pleural grooves (triangular or subpleural opacities) [2].…”

Section: Discussionsupporting

confidence: 91%

“…Those with severe BPD had the highest HRCT scores. The scoring system by Aukland et al [5] was also used by Caskey et al [7]. Comparable to our scores, their median score for adult BPD survivors was 6 (IQR 4-9) and 2 (IQR 0-4) for non-BPD individuals.…”

Section: Discussionsupporting

confidence: 72%

“…Inclusion of individuals without BPD may attenuate the observed abnormalities; however, those with a history of BPD did not have significantly higher CT scores than those without BPD [21]. Caskey et al [7] scanned adults with a history of preterm birth who either had ( n = 23) or did not have ( n = 23) BPD in the neonatal period. They reported low rates of hypoattenuation (17%) in BPD survivors.…”

Section: Discussionmentioning

confidence: 99%

“…They reported low rates of hypoattenuation (17%) in BPD survivors. Interestingly, none of those without BPD had it [7]. Regions of low attenuation in inspiratory scans presumably represent either hypoperfusion and/or hypoventilation (both contribute to an impaired gas exchange and are therefore highly relevant).…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, a report on 5 young adults with a history of BPD revealed marked structural abnormalities, particularly multifocal areas of reduced lung attenuation [3]. Since then, areas of decreased density, architectural distortion, linear/triangular/reticular opacities, bronchial wall thickening, and evidence of air trapping and emphysema have been reported in children, adolescents, and adult survivors of old BPD [4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Ronkainen¹,

Perhomaa

Mattila

et al. 2017

Neonatology

View full text Add to dashboard Cite

Background: A new pattern of bronchopulmonary dysplasia (BPD) has emerged with the improved survival of preterm children. Objectives: Our aim was to characterize structural abnormalities associated with new BPD and to evaluate whether the severity of high-resolution computed tomography (HRCT) changes is associated with lung function. Methods: HRCT scans were performed on 21 schoolchildren with a history of new BPD (mild, n = 9; moderate, n = 4; and severe, n = 8) with a mean age of 12.7 years (range: 8.7-16.7). Scans were interpreted by 2 radiologists using a structured scoring system. Spirometry (forced expiratory volume in 1 s [FEV₁] and maximum mid-expiratory flow [MMEF]) and the diffusion capacity of the lung for carbon monoxide (DLCO) were measured. Results: At least 1 HRCT abnormality was evident in 17 children (81%), including linear-to-triangular subpleural opacities (71%), air trapping (29%), mosaic perfusion (24%), peribronchial thickening (14%), and emphysema (14%). The HRCT score was higher in the severe BPD group (11.50; 95% CI 2.86-20.14) than in the mild or moderate BPD group (1.39; 95% CI 0.24-2.54, and 2.75; 95% CI 0.28-5.22, respectively). HRCT scores were inversely related to FEV₁ (β -4.23; 95% CI -6.97 to -1.49, p = 0.004) and MMEF (β -3.45; 95% CI -6.10 to -0.80, p = 0.013) but not to DLCO. The duration of the initial mechanical ventilation was associated with HRCT scores (p = 0.014). Conclusions: Structural lung abnormalities are common among schoolchildren with a history of new BPD, resembling abnormalities described in the presurfactant era. HRCT abnormalities are associated with the duration of early mechanical ventilation and the severity of BPD and they are correlated with spirometry.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Ronkainen¹,

Perhomaa

Mattila

et al. 2017

Neonatology

View full text Add to dashboard Cite

show abstract

Heterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial

Gentle

Rysavy

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceExtremely preterm infants who develop bronchopulmonary dysplasia (BPD) are at a higher risk for adverse pulmonary and neurodevelopmental outcomes. In the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) Hydrocortisone Trial, hydrocortisone neither reduced rates of BPD or death nor increased rates of neurodevelopmental impairment (NDI) or death.ObjectiveTo determine whether estimated risk for grades 2 to 3 BPD or death is associated with the effect of hydrocortisone on the composite outcomes of (1) grades 2 to 3 BPD or death and (2) moderate or severe NDI or death.Design, Setting, and ParticipantsThis secondary post hoc analysis used data from the NICHD NRN Hydrocortisone Trial, which was a double-masked, placebo-controlled, randomized clinical trial conducted in 19 US academic centers. The NICHD HRN Hydrocortisone Trial enrolled infants born at a gestational age of less than 30 weeks who received mechanical ventilation for at least 7 days, including at the time of enrollment, and who were aged 14 to 28 postnatal days. Infants were enrolled between August 22, 2011, and February 4, 2018, with follow-up between 22 and 26 months of corrected age completed on March 29, 2020. Data were analyzed from September 13, 2021, to March 25, 2023.InterventionInfants were randomized to 10 days of hydrocortisone or placebo treatment.Main Outcomes and MeasuresInfants’ baseline risk of grades 2 to 3 BPD or death was estimated using the NICHD Neonatal BPD Outcome Estimator. Differences in absolute and relative treatment effects by baseline risk were evaluated using interaction terms in models fitted to the efficacy outcome of grades 2 to 3 BPD or death and the safety outcome of moderate or severe NDI or death by follow-up.ResultsAmong the 799 infants included in the analysis (421 boys [52.7%]), the mean (SD) gestational age was 24.9 (1.5) weeks, and the mean (SD) birth weight was 715 (167) g. The mean estimated baseline risk for grades 2 to 3 BPD or death was 54% (range, 18%-84%) in the study population. The interaction between treatment group and baseline risk was not statistically significant on a relative or absolute scale for grades 2 to 3 BPD or death; the size of the effect ranged from a relative risk of 1.13 (95% CI, 0.82-1.55) in quartile 1 to 0.94 (95% CI, 0.81-1.09) in quartile 4. Similarly, the interaction between treatment group and baseline risk was not significant on a relative or absolute scale for moderate or severe NDI or death; the size of the effect ranged from a relative risk of 1.04 (95% CI, 0.80-1.36) in quartile 1 to 0.99 (95% CI, 0.80-1.22) in quartile 4.Conclusions and RelevanceIn this secondary analysis of a randomized clinical trial, the effect of hydrocortisone vs placebo was not appreciably modified by baseline risk for grades 2 to 3 BPD or death.Trial RegistrationClinicalTrials.gov Identifier: NCT01353313

show abstract

Chemical shift of ¹²⁹Xe dissolved in red blood cells: Application to a rat model of bronchopulmonary dysplasia

Friedlander

Zanette

Lindenmaier

et al. 2019

Magnetic Resonance in Med

View full text Add to dashboard Cite

Purpose To measure the chemical shift of hyperpolarized 129Xe dissolved in the red blood cells(δRBC) of a cohort of rats exposed to hyperoxia and intermittent hypoxia (IH) to mimic human bronchopulmonary dysplasia, and to investigate the effect of xenon‐blood distribution time on δRBC. Methods δRBC was measured from spectra acquired using a chemical shift saturation recovery sequence from 15 Sprague‐Dawley rats exposed to hyperoxia‐IH and 10 age‐matched control rats. Sensitization to the xenon‐blood distribution time was achieved by varying the time between saturation pulses, τ. δRBC was compared with blood fraction measured by histology of the cohort and blood oxygenation measured directly using pulse oximetry following a hypoxic challenge in an identically exposed cohort. Results The mean δRBC in the hyperoxia‐IH exposed rats was 0.55 ± 0.04 ppm lower than that of the healthy cohort (P = .0038), and this difference did not depend on τ (P = .996). The blood fraction of the exposed cohort was lower than that of the healthy cohort (P = .0397). Oximetry measurements showed that the baseline arterial oxygen saturation (SaO2) of each cohort was not different (P = .72), but after a hypoxic challenge, the SaO2 of the exposed cohort was lower than that of the healthy cohort (P = .003). Conclusion δRBC is reduced in rats exposed to hyperoxia‐IH compared with control rats. The change in δRBC is consistent with enhanced blood oxygen desaturation of the exposed cohort measured by pulse oximetry during a hypoxic challenge. This suggests that the observed change in δRBC reflects enhanced desaturation in the hyperoxia‐IH exposed cohort compared with the healthy cohort.

show abstract

Structural and Functional Lung Impairment in Adult Survivors of Bronchopulmonary Dysplasia

Abstract: Adult preterm birth survivors, especially those who developed BPD, continue to experience respiratory symptoms and exhibit clinically important levels of pulmonary impairment.

Cited by 106 publications

References 32 publications

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Heterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial

Chemical shift of ¹²⁹Xe dissolved in red blood cells: Application to a rat model of bronchopulmonary dysplasia

Contact Info

Product

Resources

About

Structural and Functional Lung Impairment in Adult Survivors of Bronchopulmonary Dysplasia

Abstract: Adult preterm birth survivors, especially those who developed BPD, continue to experience respiratory symptoms and exhibit clinically important levels of pulmonary impairment.

Cited by 106 publications

References 32 publications

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Heterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial

Chemical shift of 129Xe dissolved in red blood cells: Application to a rat model of bronchopulmonary dysplasia

Contact Info

Product

Resources

About

Chemical shift of ¹²⁹Xe dissolved in red blood cells: Application to a rat model of bronchopulmonary dysplasia