Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition

Bancalari, Eduardo; Claure, Nelson; Sosenko, Ilene R.S.

doi:10.1016/s1084-2756(02)00192-6

Cited by 385 publications

(346 citation statements)

References 42 publications

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“…This manifests as respiratory distress in the early neonatal period and can develop into bronchopulmonary dysplasia (BPD), currently defined as a supplemental oxygen requirement at 36 weeks postmenstrual age, with characteristic radiographic findings (2). A recent survey reported that the incidence of BPD ranged from 67% among infants with birth weights of 500 to 750 g to Ͻ1% in infants weighing 1,250 to 2,500 g (2).…”

mentioning

confidence: 99%

Characterization of Ureaplasmas Isolated from Preterm Infants with and without Bronchopulmonary Dysplasia

Katz¹,

Patel²,

Duffy³

et al. 2005

J Clin Microbiol

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A PCR assay was used to analyze endotracheal aspirates from preterm infants for Ureaplasma parvum versus U. urealyticum. U. parvum was detected more often than U. urealyticum. There was no significant difference or trend in the prevalence of either species between infants with or without bronchopulmonary dysplasia when isolated alone.The major factor leading to high morbidity and mortality of preterm infants is pulmonary immaturity. This manifests as respiratory distress in the early neonatal period and can develop into bronchopulmonary dysplasia (BPD), currently defined as a supplemental oxygen requirement at 36 weeks postmenstrual age, with characteristic radiographic findings (2). A recent survey reported that the incidence of BPD ranged from 67% among infants with birth weights of 500 to 750 g to Ͻ1% in infants weighing 1,250 to 2,500 g (2).Development of BPD is multifactorial and is related to pulmonary immaturity, oxidant injury due to high levels of inspired oxygen, and volutrauma associated with mechanical ventilation. However, recent research has focused on the roles of perinatal infection and the inflammatory response as critical factors influencing chronic lung injury (7, 16). Particular attention has been paid to the role of Ureaplasma species, fastidious bacteria found in the lower genital tracts of 40 to 80% of asymptomatic women (4). Rates of vertical transmission range from 18 to 88%, varying inversely with gestational age (6,8,12,24,25). Ureaplasma spp. are the most common microorganisms isolated from inflamed placentas and the lower respiratory tracts of neonates and are proven causes of neonatal pneumonia (4). Since initial reports associating ureaplasmal colonization and development of BPD were published in 1988 (5, 23, 26), more than 30 studies have been conducted. Most, but not all, have supported this association, despite major changes in the pulmonary management of very-low-birth-weight infants, such as exogenous surfactant, antenatal corticosteroid administration, and high frequency ventilation.

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mentioning

confidence: 99%

Characterization of Ureaplasmas Isolated from Preterm Infants with and without Bronchopulmonary Dysplasia

Katz¹,

Patel²,

Duffy³

et al. 2005

J Clin Microbiol

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“…However, little is known about energy requirements in later childhood. Those children with history of BPD can develop chronic reduced lung compliance and increased airway resistance (Bancalari et al, 2003). Several studies have shown that children with history of BPD often suffer from undernutrition and growth retardation (Kurzner et al, 1988;De Meer et al, 1997;Farrell and Fiascone, 1997;Gregoire et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Comparison of resting energy expenditure in bronchopulmonary dysplasia to predicted equation

et al. 2006

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Objective: Children with bronchopulmonary dysplasia (BPD) often suffer from growth failure because of disturbances in energy balance with an increase of resting energy expenditure (REE). Evaluation of REE is a useful tool for nutritional management. Indirect calorimetry is an elective method for measuring REE, but it is time consuming and requires rigorous procedure. The objective of this study was to test accuracy of prediction equation to evaluate REE in BPD children. Patients and methods: Fifty-two children aged 4-10 years with BPD (30 boys and 22 girls) and 30 healthy lean children (20 boys and 10 girls) were enrolled. In this study, indirect calorimetry was compared to four prediction equations (Schoffield-W, Schoffield-HW, Harris-Benedict and Food and Agriculture Organization equation) using Bland-Altman pair wise comparison. Results: The Harris-Benedict equation was the best equation to predict REE in children with BPD, and Schoffield-W was the best in healthy children. For the children with chronic lung disease of prematurity the Harris-Benedict equation showed the lowest mean predicted REEÀREE measured by indirect calorimetry difference (difference ¼ 15 kcal/day; limits of agreement À266 and 236 kcal/day; 95% confidence interval for the bias À207 to 177 kcal/day), and graphically, the best agreement. For the group of healthy children, it was the Schofield-W equation (À2.9 kcal/day; limits of agreement À275 and 269 kcal/day; 95% confidence interval for the bias À171 to 165 kcal/day), and graphically, the best agreement. Conclusion: Differences in prediction equation are minimal compared to calorimetry. Prediction equation could be useful in the management of children with BPD.

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“…Severe airway injury and fibrosis characterizing 'classical CLD', being replaced by arrested lung development and alveolar hypoplasia, which are the features of 'atypical CLD'. 2 Chronic lung disease is a major cause of long-term pulmonary sequelae in early childhood. It is associated with bronchial obstruction and hyperresponsiveness that may persist until school age or adulthood.…”

Section: Introductionmentioning

confidence: 99%

Lung function measurement in prematurely born preschool children with and without chronic lung disease

et al. 2008

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Objective: Prematurely born infants often have recurrent wheeze and long-term respiratory morbidity at follow-up. Assessment of airways obstruction in preschool children is feasible using the interrupter resistance (Rint) but has rarely been examined in preterm children with and without chronic lung disease (CLD). The objective of this study was to determine lung function measured by the interrupter technique, its feasibility in the ambulatory setting and respiratory health in prematurely born preschool children with and without CLD.Study Design: Preterm children of 2 to 4 years with severe CLD (>30% oxygen at 36 weeks and discharged home receiving supplemental oxygen) (n ¼ 43, median gestational age 27 weeks and median birth weight 995 g) and without CLD (n ¼ 33, median gestational age 29 weeks and median birth weight 1366 g) attempting lung function test for the first time were enrolled. Respiratory symptoms score was calculated using a questionnaire. A single set of 10 consecutive Rint measurements was obtained using a portable device (MicroRint). Median of at least five occlusions with consistent shape of mouth pressure-time curves was taken to be a Rint measurement. To assess feasibility the children were categorized as 'satisfactory', 'failure' and 'rejected' depending on the outcome of the test. Outcome variables were respiratory symptoms score and Rint.Result: Satisfactory Rint measurement was obtained in 46 (61%) children, 9 (36%) 2-year olds, 17 (65%) 3-year olds and 20 (80%) 4-year olds. As compared with the preterm control children (n ¼ 18), CLD children (n ¼ 28) had significantly higher respiratory symptoms score (18.5 vs 6, P<0.01) and Rint expressed as absolute values (kPa l À1 ) and z-scores (1.33 vs 1.16 and 1.42 vs 1.0, P<0.01), respectively. Conclusion:Rint measurement is feasible in prematurely born children of preschool age in the ambulatory setup. Preschool children with severe CLD may be identified from preterm children without CLD by increased Rint that may be used as a screening tool and as an outcome measure for interventions.

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Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition

Cited by 385 publications

References 42 publications

Characterization of Ureaplasmas Isolated from Preterm Infants with and without Bronchopulmonary Dysplasia

Characterization of Ureaplasmas Isolated from Preterm Infants with and without Bronchopulmonary Dysplasia

Comparison of resting energy expenditure in bronchopulmonary dysplasia to predicted equation

Lung function measurement in prematurely born preschool children with and without chronic lung disease

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