The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants

Abstract

Background Distinct patterns of early respiratory dysfunction are described in very preterm infants. Although mostly attributed to pulmonary parenchymal disease, cardiac pathophysiology might play an important role in the development of these clinical signs and symptoms. Methods Preterm infants < 29 weeks’ gestation underwent cardiac ultrasounds around day 7 and day 14-21. Respiratory dysfunction patterns were classified as stable (ST), respiratory deterioration (RD) or early persistent respiratory dysfunction (EPRD) according to oxygen need. Diastolic dysfunction was diagnosed using a multi-parameter approach. Results 98 infants (mean 27 weeks) were included. The prevalence of ST, RD and EPRD was 53%, 21% and 26% respectively. Diastolic dysfunction was significantly more prevalent in the RD and EPRD groups. Risk factors for developing diastolic dysfunction were a patent ductus arteriosus and significant growth restriction. Not all infants with a PDA developed diastolic dysfunction. Conclusion Respiratory dysfunction patterns are associated with cardiac pathophysiology