Chest radiograph thoracic areas and lung volumes in infants developing bronchopulmonary dysplasia

Abstract

Summary. Objectives: To determine whether chest radiograph (CXR) thoracic areas and lung volumes differed between infants who did and did not develop BPD and according to the severity of BPD developed. Working Hypothesis: Infants developing BPD, particularly if moderate or severe, would have low CXR thoracic areas and lung volumes in the perinatal period. Study Design: Prospective study. Patient-Subject Selection: 53 infants with a median gestational age of 28 (range 24-32) weeks. Methodology: CXR thoracic areas were calculated using a Picture Archiving and Communicating System (PACS) and lung volume assessed by measurement of functional residual capacity (FRC) in the first 72 hr after birth. BPD was diagnosed if the infants were oxygen dependent beyond 28 days, mild BPD in infants no longer oxygen dependent at 36 weeks postmenstrual age (PMA) and moderate/severe BPD in infants who required supplementary oxygen with or without respiratory support at 36 weeks PMA. Results: Thirty two infants developed BPD, 21 had moderate/severe BPD. The median CXR thoracic areas were higher (P < 0.0001) and FRCs were lower (P < 0.0001) in the BPD compared to no BPD infants. The median CXR thoracic areas of the moderate/severe group (P < 0.001) and the mild group (P < 0.05) were greater than that of the no BPD group and the median FRC of the moderate/severe BPD group was lower than the no BPD group (<0.001) and the mild BPD group (P < 0.05). Conclusion: These results highlight that in the perinatal period infants developing BPD, particularly if moderate/severe, have low functional lung volumes and may have gas trapping, which likely reflects ventilation inhomogeneity.

Chorioamnionitis, lung function and bronchopulmonary dysplasia in prematurely born infants

“…Data were analysed from infants entered into a prospective study assessing the impact of chorioamnionitis on lung function (not previously reported) and from infants entered into two previous studies 11 12. Forty-seven of 82 infants were eligible from the prospective study and 33 of 12611 and 40 of 7812 from the previous two studies.…”

“…Data were analysed from infants entered into a prospective study assessing the impact of chorioamnionitis on lung function (not previously reported) and from infants entered into two previous studies 11 12. Forty-seven of 82 infants were eligible from the prospective study and 33 of 12611 and 40 of 7812 from the previous two studies. During the time period in which the three studies were undertaken, there were no changes in routine policies regarding, for example, antenatal steroid or postnatal surfactant use (Survanta was used throughout), nor were there any changes in the use of ventilatory modes.…”

NF-κB Activation Limits Airway Branching through Inhibition of Sp1-Mediated Fibroblast Growth Factor-10 Expression

“…In up to 50% of extremely preterm infants, saccular airway branching arrests, resulting in bronchopulmonary dysplasia (BPD) (7, 8). Arrested branching in BPD results in fewer alveolar units available for gas exchange and smaller overall lung volumes (9). Although many factors likely contribute to BPD pathogenesis, exposure to inflammation clearly increases BPD risk.…”

Updates on Functional Characterization of Bronchopulmonary Dysplasia – The Contribution of Lung Function Testing

“…CXR thoracic areas and FRC measurements assessed in the first 72 h after birth in 53 infants, median gestational age of 28 weeks, also demonstrated lower FRCs in the BPD group, but the CXR thoracic areas were higher in the infants who subsequently developed BPD (oxygen dependency at 28 days) perhaps indicating gas trapping. The differences were particularly marked in infants who developed moderate/severe BPD (23). The reduced Crs in the neonatal period may be due to ongoing surfactant abnormalities, edema, and atelectasis.…”