Bronchopulmonary Dysplasia: Executive Summary of a Workshop

Higgins, Rosemary D.; Jobe, Alan H.; Koso‐Thomas, Marion; Bancalari, Eduardo; Viscardi, Rose M.; Hartert, Tina V.; Ryan, Rita M.; Kallapur, Suhas G.; Steinhorn, Robin H.; Konduri, Girija G.; Davis, Stephanie D.; Thébaud, Bernard; Clyman, Ronald I.; Collaco, Joseph M.; Martin, Camilia R.; Woods, Jason C.; Finer, Neil N.; Raju, Tonse N.K.

doi:10.1016/j.jpeds.2018.01.043

Cited by 655 publications

(652 citation statements)

References 77 publications

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“…Second, SGA and PDA are well‐known unique risk factors for BPD . In the present study both factors were not significantly associated with the chest radiograph classification.…”

Section: Discussioncontrasting

confidence: 62%

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Impact of chest radiography‐based definition of bronchopulmonary dysplasia

Arai

Ito

et al. 2019

Pediatrics International

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Background Bubbly/cystic appearance on chest radiograph is an important factor in severe‐type bronchopulmonary dysplasia (BPD) in Japan. The aim of this study was to determine the perinatal characteristics and neonatal complications of the bubbly/cystic(+) group in extremely preterm infants with BPD, that is, oxygen dependency at day 28 after birth (BPD28). Methods This was a multicenter retrospective cohort study of population data from infants (birthweight, <1,500 g) enrolled in the Neonatal Research Network of Japan. Of the 15 480 infants born at <28 weeks’ gestational age (GA) between 2003 and 2012, 8,979 met the BPD28 criteria. The BPD28 infants were classified according to bubbly/cystic appearance on radiograph (±) at >28 postnatal days. Results The bubbly/cystic(+) group had lower GA and birthweight and required longer mechanical ventilation and oxygen dependency than the bubbly/cystic(−) group. After adjustment for confounding factors, bubbly/cystic appearance was an independent risk factor for home oxygen therapy at discharge. Conclusion Bubbly/cystic appearance on chest radiograph was a predictor of short‐term respiratory outcomes in infants with BPD28, which is diagnosed much earlier (≥28 postnatal days), and has a potentially different etiology to BPD36 (oxygen and/or positive pressure respiratory support dependency at 36 weeks’ postmenstrual age).

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“…Second, SGA and PDA are well‐known unique risk factors for BPD . In the present study both factors were not significantly associated with the chest radiograph classification.…”

Section: Discussioncontrasting

confidence: 62%

“…Radiology was not included in the definition of BPD, because there was no confidence in the consistency of the readings . Recently, refinements to the definition of BPD include the radiographic confirmation of parenchymal lung disease …”

Section: Classification Of Bronchopulmonary Dysplasia In Japanmentioning

confidence: 99%

Impact of chest radiography‐based definition of bronchopulmonary dysplasia

Arai

Ito

et al. 2019

Pediatrics International

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“…To overcome some of these shortcomings, a recent Eunice Kennedy National Institute of Child health and Human Development workshop proposed some refinements to the 2001 definition of BPD. This proposal attempts to categorize infants on nasal cannula oxygen therapy, infants dying due to severe lung disease prior to 36 weeks, as well as excluding infants with transitory need for respiratory support at 36 weeks or nonpulmonary causes of respiratory failure [16]. …”

Section: Evolution Of Bpd Definitionmentioning

confidence: 99%

Bronchopulmonary Dysplasia: 50 Years after the Original Description

2019

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Bronchopulmonary dysplasia (BPD) is one of the few diseases in neonatal medicine that has continued to evolve since its first description about 50 years ago. Over these years, advancements in neonatal medicine such as antenatal steroids and exogenous surfactant therapy have significantly reduced neonatal mortality and lowered the limits of viability for preterm infants. Although the incidence of BPD continues to be high, especially in extremely low birth weight infants, the clinical picture has evolved into a milder disease with low mortality or significant morbidities. This new BPD is the result of complex interactions between altered alveolar and vascular development, injury by ante- and postnatal pathogenic factors, and reparative processes in the lung. There has been significant progress in our understanding of risk factors for BPD, but challenges persist in its definition, and in finding effective preventive strategies. There are promising developments with newer preventive interventions such as mesenchymal stem cells, exosomes, immunomodulators, and growth factors, but they are still in preclinical stage. The future challenges include finding ways to define BPD based on the severity of lung pathology, which can better predict long-term outcomes, development of early predictors of lung disease, and finding innovative and evidence-based preventive and management strategies.

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“…Hirata et al reported the association of a bubbly/cystic appearance on CXR and airway obstructive lung disease in 8‐years‐old children . The 2018 revision of the National Institute of Child Health and Human Development BPD definition stated that radiographic confirmation of parenchymal lung disease was required …”

Section: Discussionmentioning

confidence: 99%

Bubbly and cystic appearance on chest radiograph of extremely preterm infants with bronchopulmonary dysplasia is associated with wheezing disorder

Arai

Ito

et al. 2019

Acta Paediatrica

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Aim Bubbly/cystic appearance on chest X‐ray (CXR) is an important factor in cases of severe bronchopulmonary dysplasia (BPD). We aimed to determine whether CXR ‐based BPD classifications obtained in extremely preterm infants with oxygen dependency at 28 days after birth (BPD28) is associated with wheezing disorders. Methods This was a multicentre retrospective cohort study of population data from infants (body weight, <1500 g) enrolled in the Neonatal Research Network of Japan. Of the 15 480 infants born at <28 weeks of gestation between 2003 and 2012, 8979 met the BPD28 criteria, and 4007 were classified as the no BPD28 group. BPD28 infants were classified according to the bubbly/cystic or no bubbly/cystic appearance on CXR at postnatal ≧28 days. The effects on wheezing disorder at 3 years of age were analysed. Results Bubbly/cystic BPD28 infants showed higher rates of wheezing disorders compared with no BPD28 infants. Bubbly/cystic BPD28 (odds ratio 1.7; 95% confidence interval, 1.3‐2.2) was a significant independent factor for wheezing disorders. Conclusion A bubbly/cystic appearance on CXR with BPD28 was a potential risk factor of wheezing disorders at 3 years of age. This may be a useful early diagnostic tool at ≧28 postnatal days in extremely preterm infants.

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Bronchopulmonary Dysplasia: Executive Summary of a Workshop

Cited by 655 publications

References 77 publications

Impact of chest radiography‐based definition of bronchopulmonary dysplasia

Impact of chest radiography‐based definition of bronchopulmonary dysplasia

Bronchopulmonary Dysplasia: 50 Years after the Original Description

Bubbly and cystic appearance on chest radiograph of extremely preterm infants with bronchopulmonary dysplasia is associated with wheezing disorder

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