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BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations.

Liu J, Chen SW, Liu F, Wang Y, Kong XY, Li QP, Huang JJ - Medicine (Baltimore) (2014)

Bottom Line: This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence (LTOD) in premature infants using lung ultrasound.Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia (BPD).Among the 50 patients studied, there were 9 cases of atelectasis, 4 cases of pneumonia, 2 cases of severe pulmonary edema, and 3 cases of pulmonary edema and consolidation that coexisted with BPD.The oxygen dependence of the babies either completely resolved or significantly decreased following appropriate treatments.More than one-third of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD.Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in patients with BPD, and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neonatology and NICU of Bayi Children's Hospital (JL, S-WC, FL, YW, X-YK, Q-PL, J-JH), Beijing Military General Hospital, Beijing; and Graduate School of Southern Medical University (S-WC, FL, YW), Guangzhou, China.

ABSTRACT
Lung ultrasound has been extensively used to diagnose many types of lung disease. This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence (LTOD) in premature infants using lung ultrasound.Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia (BPD).Among the 50 patients studied, there were 9 cases of atelectasis, 4 cases of pneumonia, 2 cases of severe pulmonary edema, and 3 cases of pulmonary edema and consolidation that coexisted with BPD. The oxygen dependence of the babies either completely resolved or significantly decreased following appropriate treatments.More than one-third of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD. Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in patients with BPD, and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.

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Related in: MedlinePlus

Pneumonia. GA 29+2 weeks, birth weight 1200 g, Apgar score 8-10-10 points/1-5-10 min. This patient was maintained on a ventilator because of RDS and was diagnosed with BPD clinically because oxygen therapy was required after 58 days of life. A lung ultrasound showed large consolidations with irregular edges, as well as air bronchograms bilaterally (A—left lung, B—right lung) (arrows). The pleural line was either blurred or disappeared, and the A-line disappeared. This infant was diagnosed with bilateral pneumonia, which was the reason for oxygen dependence. BPD = bronchopulmonary dysplasia, GA = gestational age, RDS = respiratory distress syndrome.
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Figure 2: Pneumonia. GA 29+2 weeks, birth weight 1200 g, Apgar score 8-10-10 points/1-5-10 min. This patient was maintained on a ventilator because of RDS and was diagnosed with BPD clinically because oxygen therapy was required after 58 days of life. A lung ultrasound showed large consolidations with irregular edges, as well as air bronchograms bilaterally (A—left lung, B—right lung) (arrows). The pleural line was either blurred or disappeared, and the A-line disappeared. This infant was diagnosed with bilateral pneumonia, which was the reason for oxygen dependence. BPD = bronchopulmonary dysplasia, GA = gestational age, RDS = respiratory distress syndrome.

Mentions: Among the 50 patients enrolled in our study, there were 9 cases of atelectasis (Figure 1) (4 involved BPD coexisting with atelectasis), 4 cases of pneumonia (Figure 2) (2 involved BPD coexisting with pneumonia), 2 cases of severe pulmonary edema (Figure 3) (which did not include mild pulmonary edema experienced during recovery, Figure 4), and 3 cases of pulmonary edema accompanied by focal pulmonary consolidation (Figure 5). These results indicated that more than one-third (18/50 = 36%) of our patients with LTOD either did not actually have BPD or did not have BPD alone. After receiving either endotracheal lavage or pulmonary physical therapy, which resulted in improved atelectasis and aided in the resolution of both inflammation and pulmonary edema, these patients experienced either significant improvements or total resolution of their respiratory symptoms.


BPD, Not BPD, or iatrogenic BPD: findings of lung ultrasound examinations.

Liu J, Chen SW, Liu F, Wang Y, Kong XY, Li QP, Huang JJ - Medicine (Baltimore) (2014)

Pneumonia. GA 29+2 weeks, birth weight 1200 g, Apgar score 8-10-10 points/1-5-10 min. This patient was maintained on a ventilator because of RDS and was diagnosed with BPD clinically because oxygen therapy was required after 58 days of life. A lung ultrasound showed large consolidations with irregular edges, as well as air bronchograms bilaterally (A—left lung, B—right lung) (arrows). The pleural line was either blurred or disappeared, and the A-line disappeared. This infant was diagnosed with bilateral pneumonia, which was the reason for oxygen dependence. BPD = bronchopulmonary dysplasia, GA = gestational age, RDS = respiratory distress syndrome.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4616337&req=5

Figure 2: Pneumonia. GA 29+2 weeks, birth weight 1200 g, Apgar score 8-10-10 points/1-5-10 min. This patient was maintained on a ventilator because of RDS and was diagnosed with BPD clinically because oxygen therapy was required after 58 days of life. A lung ultrasound showed large consolidations with irregular edges, as well as air bronchograms bilaterally (A—left lung, B—right lung) (arrows). The pleural line was either blurred or disappeared, and the A-line disappeared. This infant was diagnosed with bilateral pneumonia, which was the reason for oxygen dependence. BPD = bronchopulmonary dysplasia, GA = gestational age, RDS = respiratory distress syndrome.
Mentions: Among the 50 patients enrolled in our study, there were 9 cases of atelectasis (Figure 1) (4 involved BPD coexisting with atelectasis), 4 cases of pneumonia (Figure 2) (2 involved BPD coexisting with pneumonia), 2 cases of severe pulmonary edema (Figure 3) (which did not include mild pulmonary edema experienced during recovery, Figure 4), and 3 cases of pulmonary edema accompanied by focal pulmonary consolidation (Figure 5). These results indicated that more than one-third (18/50 = 36%) of our patients with LTOD either did not actually have BPD or did not have BPD alone. After receiving either endotracheal lavage or pulmonary physical therapy, which resulted in improved atelectasis and aided in the resolution of both inflammation and pulmonary edema, these patients experienced either significant improvements or total resolution of their respiratory symptoms.

Bottom Line: This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence (LTOD) in premature infants using lung ultrasound.Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia (BPD).Among the 50 patients studied, there were 9 cases of atelectasis, 4 cases of pneumonia, 2 cases of severe pulmonary edema, and 3 cases of pulmonary edema and consolidation that coexisted with BPD.The oxygen dependence of the babies either completely resolved or significantly decreased following appropriate treatments.More than one-third of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD.Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in patients with BPD, and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Neonatology and NICU of Bayi Children's Hospital (JL, S-WC, FL, YW, X-YK, Q-PL, J-JH), Beijing Military General Hospital, Beijing; and Graduate School of Southern Medical University (S-WC, FL, YW), Guangzhou, China.

ABSTRACT
Lung ultrasound has been extensively used to diagnose many types of lung disease. This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence (LTOD) in premature infants using lung ultrasound.Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia (BPD).Among the 50 patients studied, there were 9 cases of atelectasis, 4 cases of pneumonia, 2 cases of severe pulmonary edema, and 3 cases of pulmonary edema and consolidation that coexisted with BPD. The oxygen dependence of the babies either completely resolved or significantly decreased following appropriate treatments.More than one-third of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD. Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in patients with BPD, and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.

Show MeSH
Related in: MedlinePlus