Encouraging Pulmonary Outcome for Surviving, Neurologically Intact, Extremely Premature Infants in the Postsurfactant Era

Kaplan, Eytan; Bar‐Yishay, Ephraim; Prais, Dario; Klinger, G; Mei-Zahav, Meir; Mussaffi, Huda; Steuer, Guy; Hananya, Shai; Matyashuk, Yelena; Gabarra, Nassrin; Sirota, Lea; Blau, Hannah

doi:10.1378/chest.11-1562

Cited by 66 publications

(99 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12,30,41,42 We found that one quarter of children born extremely preterm responded positively to pharmacological bronchodilation, implying a therapeutic way forward. 21 Nevertheless, the post bronchodilator FEV 1 was still significantly lower in the preterm group than in controls (data not shown), indicating only partially reversible airways.…”

Section: Clinical Aspects Of the Resultsmentioning

confidence: 78%

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

Section: Clinical Aspects Of the Resultsmentioning

confidence: 78%

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Thunqvist

Tufvesson

Bjermer

et al. 2017

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Previous reports on lung function of former preterm children have provided evidence of airway obstruction [9][10][11][12][13], air trapping [10,12,13] and reduced diffusing capacity of the lung for carbon monoxide [10,12,13]. However, only one study has assessed global ventilation distribution in school-aged children born extremely preterm [10].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown evidence of airway obstruction [9][10][11][12][13] and air trapping [10,12,13] at school age in such populations. However, few studies have specifically examined ventilation inhomogeneity as a biomarker of peripheral lung function, and with inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Functional evidence for continued alveolarisation in former preterms at school age?

et al. 2015

View full text Add to dashboard Cite

Prematurity is the most common disruptor of lung development. The aim of our study was to examine the function of the more vulnerable peripheral airways in former preterm children by multiplebreath washout (MBW) measurements.86 school-aged children, born between 24 and 35 weeks of gestation and 49 term-born children performed nitrogen MBW. Lung clearance index (LCI), and slope III-derived Scond and Sacin were assessed as markers for global, convection-dependent and diffusion-convection-dependent ventilation inhomogeneity, respectively.We analysed the data of 77 former preterm (mean (range) age 9.5 (7.2-12.8) years) and 46 term-born children (mean age 9.9 (6.0-15.9) years). LCI and Sacin did not differ between preterm and term-born children. Scond was significantly elevated in preterm compared to term-born participants (mean difference z-score 1.74, 95% CI 1.17-2.30; p<0.001), with 54% of former preterm children showing elevated Scond. In multivariable regression analysis Scond was significantly related only to gestational age (R 2 =0.37). Normal Sacin provides evidence for a functionally normal alveolar compartment, while elevated Scond indicates impaired function of more proximal conducting airways. Together, our findings support the concept of continued alveolarisation, albeit with "dysanaptic" lung growth in former preterm children. @ERSpublications Evidence for a prematurity-related dysanaptic lung growth in former preterm children

show abstract

“…In our unit during this period post-natal steroids were used predominantly for ventilator-dependent infants with BPD and surfactant was used for treatment of preterm infants with respiratory distress syndrome, rather than prophylaxis which later became accepted practice. In a recent study of infants born preterm in the post-surfactant era and studied in mid-childhood (mean¡SD age 10¡1.5 years), the majority of those who developed BPD had only mild disease (21 out of 28 studied) with little evidence of lung function impairment compared to preterm and term controls [9]. While our results may not necessarily be generalisable to the later cohorts of preterm infants who develop ''new'' BPD [24], we believe our findings are applicable to the large number of BPD survivors currently in their third and fourth decades of life who may have unrecognised or incorrectly diagnosed respiratory disease.…”

Section: Discussionmentioning

confidence: 99%

“…In the recently reported EPICure study, lung function was measured at 11 years in children born extremely preterm and abnormal baseline spirometry was found in almost half of the children tested, of whom 81% had prior BPD [8]. In contrast, a recent study of survivors of extreme prematurity reaching mid-childhood reported encouraging pulmonary outcomes, but most of those studied had either no or only mild BPD [9]. In the study by DOYLE et al [10], subjects born with VLBW and who developed BPD had poorer lung function in late adolescence than those without BPD, with evidence of more rapid decline in lung function.…”

Section: Introductionmentioning

confidence: 99%

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

et al. 2013

View full text Add to dashboard Cite

More infants with bronchopulmonary dysplasia (BPD) now survive to adulthood, but little is known regarding persisting respiratory impairment. We report respiratory symptoms, lung function and health-related quality of life (HRQoL) in adult BPD survivors compared with preterm (non-BPD) and fullterm controls.Respiratory symptoms (European Community Respiratory Health Survey) and HRQoL (EuroQol (EQ)-5D) were measured in 72 adult BPD survivors (mean¡SD study age 24.1¡4.0 years; mean¡SD gestational age 27.1¡2.1 weeks; and mean¡SD birth weight 955¡256 g) cared for in the regional neonatal intensive care unit, Royal Maternity Hospital, Belfast, UK (between 1978 and 1993). These were compared with 57 non-BPD controls (mean¡SD study age 25.3¡4.0 years; mean¡SD gestational age 31.0¡2.5 weeks; and mean¡SD birth weight 1238¡222 g) and 78 full-term controls (mean¡SD study age 25.7¡3.8 years; mean¡SD gestational age 39.7¡1.4 weeks; and mean¡SD birth weight 3514¡456 g) cared for at the same hospital. Spirometry was performed on 56 BPD, 40 non-BPD and 55 full-term participants.BPD subjects were twice as likely to report wheeze and three times more likely to use asthma medication than controls. BPD adults had significantly lower forced expiratory volume in 1 s and forced expiratory flow at 25-75% of forced vital capacity than both the preterm non-BPD and full-term controls (all p,0.01). Mean EQ-5D was 6 points lower in BPD adults compared to full-term controls (p,0.05).BPD survivors have significant respiratory and quality of life impairment persisting into adulthood.@ERSpublications Adult BPD survivors are more likely to have more respiratory symptoms, impaired health status and airflow obstruction than controls

show abstract

Encouraging Pulmonary Outcome for Surviving, Neurologically Intact, Extremely Premature Infants in the Postsurfactant Era

Cited by 66 publications

References 42 publications

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Lung function after extremely preterm birth—A population‐based cohort study (EXPRESS)

Functional evidence for continued alveolarisation in former preterms at school age?

Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia

Contact Info

Product

Resources

About