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Development of lung function in very low birth weight infants with or without bronchopulmonary dysplasia: longitudinal assessment during the first 15 months of corrected age.

Schmalisch G, Wilitzki S, Roehr CC, Proquitté H, Bührer C - BMC Pediatr (2012)

Bottom Line: Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRC(pleth)), maximal expiratory flow at the FRC (V'max (FRC)), or blood gas (pO2, pCO2) levels.Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways) were significantly lower in former BPD infants compared to controls.However, these differences became non-significant after normalization to body weight.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neonatology, Charité University Medicine, Berlin, Germany. gerd.schmalisch@charite.de

ABSTRACT

Background: Very low birth weight (VLBW) infants (< 1,500 g) with bronchopulmonary dysplasia (BPD) develop lung damage caused by mechanical ventilation and maturational arrest. We compared functional lung development after discharge from hospital between VLBW infants with and without BPD.

Methods: Comprehensive lung function assessment was performed at about 50, 70, and 100 weeks of postmenstrual age in 55 sedated VLBW infants (29 with former BPD [O2 supplementation was given at 36 weeks of gestational age] and 26 VLBW infants without BPD [controls]). Mean gestational age (26 vs. 29 weeks), birth weight (815 g vs. 1,125 g), and the proportion of infants requiring mechanical ventilation for ≥7 d (55% vs. 8%), differed significantly between BPD infants and controls.

Results: Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRC(pleth)), maximal expiratory flow at the FRC (V'max (FRC)), or blood gas (pO2, pCO2) levels. Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways) were significantly lower in former BPD infants compared to controls. However, these differences became non-significant after normalization to body weight.

Conclusions: Although somatic growth and the development of some lung functional parameters lag in former BPD infants, the lung function of such infants appears to develop in line with that of non-BPD infants when a body weight correction is applied. Longitudinal lung function testing of preterm infants after discharge from hospital may help to identify former BPD infants at risk of incomplete recovery of respiratory function; such infants are at risk of later respiratory problems.

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Changes over time in respiratory compliance normalized to actual body weight (top), and specific compliance (bottom), in infants with and without former BPD (the mode of presentation is the same as that of Figure 1).
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Figure 5: Changes over time in respiratory compliance normalized to actual body weight (top), and specific compliance (bottom), in infants with and without former BPD (the mode of presentation is the same as that of Figure 1).

Mentions: As with the tidal breathing parameters, the development over time of all lung mechanical parameters differed significantly (p < 0.001) between the two groups (Figure 4), but the covariates did not significantly influence such variations. In former BPD infants, Crs was significantly lower than in non-BPD infants, but rose in parallel as PMA increased. After normalization of Crs values to actual body weight (Figure 5), the differences between the groups became statistically insignificant; both groups developed similarly. Specific compliance (CRS/FRC; the elasticity of a unit of lung volume) increased in both groups, but apparently more rapidly in former BPD infants (Figure 5). At 15 months of age, the specific compliance was nearly identical in either group.


Development of lung function in very low birth weight infants with or without bronchopulmonary dysplasia: longitudinal assessment during the first 15 months of corrected age.

Schmalisch G, Wilitzki S, Roehr CC, Proquitté H, Bührer C - BMC Pediatr (2012)

Changes over time in respiratory compliance normalized to actual body weight (top), and specific compliance (bottom), in infants with and without former BPD (the mode of presentation is the same as that of Figure 1).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3362756&req=5

Figure 5: Changes over time in respiratory compliance normalized to actual body weight (top), and specific compliance (bottom), in infants with and without former BPD (the mode of presentation is the same as that of Figure 1).
Mentions: As with the tidal breathing parameters, the development over time of all lung mechanical parameters differed significantly (p < 0.001) between the two groups (Figure 4), but the covariates did not significantly influence such variations. In former BPD infants, Crs was significantly lower than in non-BPD infants, but rose in parallel as PMA increased. After normalization of Crs values to actual body weight (Figure 5), the differences between the groups became statistically insignificant; both groups developed similarly. Specific compliance (CRS/FRC; the elasticity of a unit of lung volume) increased in both groups, but apparently more rapidly in former BPD infants (Figure 5). At 15 months of age, the specific compliance was nearly identical in either group.

Bottom Line: Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRC(pleth)), maximal expiratory flow at the FRC (V'max (FRC)), or blood gas (pO2, pCO2) levels.Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways) were significantly lower in former BPD infants compared to controls.However, these differences became non-significant after normalization to body weight.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neonatology, Charité University Medicine, Berlin, Germany. gerd.schmalisch@charite.de

ABSTRACT

Background: Very low birth weight (VLBW) infants (< 1,500 g) with bronchopulmonary dysplasia (BPD) develop lung damage caused by mechanical ventilation and maturational arrest. We compared functional lung development after discharge from hospital between VLBW infants with and without BPD.

Methods: Comprehensive lung function assessment was performed at about 50, 70, and 100 weeks of postmenstrual age in 55 sedated VLBW infants (29 with former BPD [O2 supplementation was given at 36 weeks of gestational age] and 26 VLBW infants without BPD [controls]). Mean gestational age (26 vs. 29 weeks), birth weight (815 g vs. 1,125 g), and the proportion of infants requiring mechanical ventilation for ≥7 d (55% vs. 8%), differed significantly between BPD infants and controls.

Results: Both body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRC(pleth)), maximal expiratory flow at the FRC (V'max (FRC)), or blood gas (pO2, pCO2) levels. Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways) were significantly lower in former BPD infants compared to controls. However, these differences became non-significant after normalization to body weight.

Conclusions: Although somatic growth and the development of some lung functional parameters lag in former BPD infants, the lung function of such infants appears to develop in line with that of non-BPD infants when a body weight correction is applied. Longitudinal lung function testing of preterm infants after discharge from hospital may help to identify former BPD infants at risk of incomplete recovery of respiratory function; such infants are at risk of later respiratory problems.

Show MeSH
Related in: MedlinePlus