Structural and functional ventilatory impairment in infants with severe bronchopulmonary dysplasia

Mastrigt, Esther van; Kakar, Ellaha; Ciet, Pierluigi; Dekker, Herman T. den; Joosten, Koen; Kalkman, Patricia; Swarte, Renate; Kroon, Abraham A.; Tiddens, Harm A.W.M.; Jongste, Johan C. de; Pijnenburg, Mariëlle W.

doi:10.1002/ppul.23696

Cited by 27 publications

(36 citation statements)

References 38 publications

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“…Despite advances in neonatal care, the findings are remarkably similar to those described in the presurfactant era: the vast majority of the scans are abnormal and the main findings include linear or triangular subpleural opacities (89-95%) and hypoattenuation/hyperlucent areas (69-88%) [8,9,23,24]. Contrary to previous studies, Mahut et al [8] found no bronchial involvement in their population of 41 toddlers with a history of BPD who were referred to investigations for persistent respiratory symptoms.…”

Section: Discussionmentioning

confidence: 79%

“…There are few studies describing results from the era of new BPD [8,9,23,24]. Despite advances in neonatal care, the findings are remarkably similar to those described in the presurfactant era: the vast majority of the scans are abnormal and the main findings include linear or triangular subpleural opacities (89-95%) and hypoattenuation/hyperlucent areas (69-88%) [8,9,23,24].…”

Section: Discussionmentioning

confidence: 97%

“…A correlation between the extent of multiple hypoattenuated areas and the degree of obstruction on pulmonary function tests has been established [4]. Hypoattenuation was associated with the mean SaO 2 during overnight polysomnography and the extent of structural abnormalities associated with ventilatory function as reflected by the oxygen desaturation index in 6-month-old infants with an early diagnosis of severe new BPD [9]. On the other hand, linear opacities and subpleural opacities, rather than hyperlucent areas, correlated with functional residual capacity in infants with new BPD in another study [8].…”

Section: Discussionmentioning

confidence: 99%

“…HRCT scans at infancy after new BPD reveal abnormalities [8,9]. Recent evidence suggests that lungs grow partly by neoalveolarization throughout childhood and adolescence.…”

Section: Introductionmentioning

confidence: 99%

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Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Ronkainen¹,

Perhomaa

Mattila

et al. 2017

Neonatology

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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.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…HRCT scans at infancy after new BPD reveal abnormalities [8,9]. Recent evidence suggests that lungs grow partly by neoalveolarization throughout childhood and adolescence.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Ronkainen¹,

Perhomaa

Mattila

et al. 2017

Neonatology

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“…Patients with CP who were born preterm may have broncho‐pulmonary dysplasia, which may contribute to their pulmonary problems . This is most likely due to impaired lung function, because bronchiectasis is not commonly associated with bronchopulmonary dysplasia . Although gram‐negative bacterial colonization of the airways in the neonatal period is associated with more severe bronchopulmonary dysplasia, it is unknown if bronchopulmonary dysplasia in later life is an independent risk factor for gram‐negative colonization …”

Section: Recurrent Aspirationmentioning

confidence: 99%

Respiratory morbidity in children with cerebral palsy: an overview

Boel

Pernet²,

Toussaint³

et al. 2018

Develop Med Child Neuro

121

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Respiratory problems have a significant impact on morbidity and mortality in patients with cerebral palsy (CP). In particular, recurrent aspiration, impaired airway clearance, spinal and thoracic deformity, impaired lung function, poor nutritional status, and recurrent respiratory infections negatively affect respiratory status. Bronchopulmonary dysplasia may contribute to pulmonary problems, but asthma is not more common in CP than in the general population. We discuss treatment options for each of these factors. Multiple coexisting and interacting factors that influence the respiratory status of patients with CP should be recognized and effectively addressed to reduce respiratory morbidity and mortality. What this paper adds Respiratory problems are a significant cause of morbidity in patients with cerebral palsy (CP). Respiratory status in patients with CP is influenced by recurrent aspiration and impaired airway clearance. Spinal and thoracic deformity, impaired lung function, poor nutrition, and respiratory infections also negatively affect respiratory status. These factors should all be addressed to reduce respiratory problems in patients with CP.

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Growth and nutrition in children with established bronchopulmonary dysplasia: A review of the literature

et al. 2022

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Background Bronchopulmonary dysplasia (BPD) remains the most common late morbidity of preterm birth. Clinical care and research have largely focused on the pathogenesis and prevention of BPD. Preterm infants who develop BPD have significant medical needs that persist throughout their hospital course and continue after discharge, including those associated with growth and nutrition. The objective of this study was to review the available literature on nutrition and growth in infants with established BPD and to identify the knowledge and research gaps to provide direction for future studies. Methods We conducted a literature search in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines using Ovid MEDLINE, CINAHL, and Embase. Titles, abstracts, and full texts were independently reviewed by the authors and selected based on predetermined inclusion/exclusion criteria. Results were summarized qualitatively. Results Excluding duplicates, 2315 articles were identified. Thirty articles were selected for inclusion. We identified the following key components of nutrition support and clinical care: energy expenditure, growth, and metabolism; body composition; enteral nutrition; supplements; parenteral nutrition; and respiratory outcomes. Conclusions Despite a large body of literature describing the role of growth and nutrition in the prevention of BPD, research is lacking with respect to interventions and management in the population with established BPD. Thus, organized approaches for clinical interventions and trials with respect to growth and nutrition in infants and young children with established BPD are needed. These studies should include multiple centers because of the small numbers of patients with BPD at each site.

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Structural and functional ventilatory impairment in infants with severe bronchopulmonary dysplasia

Abstract: Most preterm infants with severe BPD have structural lung abnormalities and impaired ventilatory function early in life, partly explained by birth characteristics and infant growth.

Cited by 27 publications

References 38 publications

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Structural Pulmonary Abnormalities Still Evident in Schoolchildren with New Bronchopulmonary Dysplasia

Respiratory morbidity in children with cerebral palsy: an overview

Growth and nutrition in children with established bronchopulmonary dysplasia: A review of the literature

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