Impact of Improved Survival of Very Low-Birth-Weight Infants on Incidence and Severity of Bronchopulmonary Dysplasia

Berger, Thomas M.; Bachmann, Iris I.; Adams, Mark; Schubiger, Gregor

doi:10.1159/000078953

Cited by 43 publications

(28 citation statements)

References 22 publications

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“…While the classical form of BPD was mainly the consequence of barotrauma and oxygen toxicity, the new BPD seen in the surfactant era results from the interaction of many factors that lead to prolonged mechanical ventilation and colonization of the airway with pathogens that may trigger an inflammatory cascade. [8][9][10]19,20 In agreement with previous publications we found a significant association between LOS and BPD. 12,21 The mechanisms by which infection leads to BPD is unclear but may involve an inflammatory process, which results in damage to lung tissue.…”

Section: Discussionsupporting

confidence: 91%

“…Surfactant therapy and antenatal steroids have markedly increased the survival of the smallest infants who present a higher risk of BPD. 20 There has also been a change in the pathogenesis and the presentation of BPD. While the classical form of BPD was mainly the consequence of barotrauma and oxygen toxicity, the new BPD seen in the surfactant era results from the interaction of many factors that lead to prolonged mechanical ventilation and colonization of the airway with pathogens that may trigger an inflammatory cascade.…”

Section: Discussionmentioning

confidence: 99%

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Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso

Tapia¹,

Agost²,

Alegria³

et al. 2006

J. Pediatr. (Rio J.)

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Objective: To determine the incidence of bronchopulmonary dysplasia, its risk factors and resource utilization in a large South American population of very low birth weight infants.Methods: Prospectively collected data in infants weighing 500 to 1,500 g born in 16 NEOCOSUR Network centers from 10/2000 through 12/2003. Multivariate relative risk and 95% confidence intervals were estimated by Poisson regression with robust error variance to find factors that affected the risk of bronchopulmonary dysplasia.Results: 1,825 very low birth weight infants survivors were analyzed. Mean birth weight and gestational age were1085±279 g and 29±3 weeks respectively. Bronchopulmonary dysplasia incidence averaged 24.4% and survival without bronchopulmonary dysplasia augmented with increasing gestational age. A higher birth weight and gestational age and a female gender all decreased the risk for bronchopulmonary dysplasia. Factors that independently increased that risk were surfactant requirement, mechanical ventilation, airleak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. Bronchopulmonary dysplasia infants had more days of hospitalization (91±27 vs. 51±19), of mechanical ventilation (19±20 vs. 4±7) and oxygen therapy (72±30 vs. 8±14) in comparison with non BPD infants.Conclusions: Bronchopulmonary dysplasia incidence was 24.4% in a large South American population and is related to greater resource utilization. Population and is related to greater resource utilization. Risk factors for bronchopulmonary dysplasia in this study were: surfactant requirement, mechanical ventilation, airleak, patent ductus arteriosus, late onset sepsis and necrotizing enterocolitis. These studies may provide useful information in the design of effective preventive perinatal strategies.J Pediatr (Rio J). 2006;82(1):15-20: Bronchopulmonary dysplasia, very low birth weight, risk factors, resource utilization, neonates.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso

Tapia¹,

Agost²,

Alegria³

et al. 2006

J. Pediatr. (Rio J.)

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“…1 Advances in neonatology and improved survival means that more preterm infants will be discharged into the care of pediatric primary care providers. [2][3][4][5] Many of these infants have experienced significant neonatal morbidities including bronchopulmonary dysplasia (BPD), sepsis, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and retinopathy of prematurity. These conditions increase the risk for mild-to-severe adverse outcomes after neonatal intensive care unit (NICU) discharge including rehospitalization for respiratory infections or reactive airway disease, poor growth, neurosensory problems, cerebral palsy and behavioral disorders.…”

Section: Introductionmentioning

confidence: 99%

Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications

et al. 2008

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Objective: To determine the frequency and risk factors for clinic and pharmacy use in preterm infants during the first year after neonatal intensive care unit (NICU) discharge.Study Design: We analyzed clinic visits and prescriptions in a cohort of 23 to 32 weeks infants. We constructed multivariable regression models to determine risk factors for high use.Result: The 892 preterm infants experienced 18 346 pediatric visits (mean 20 visits per infant per year) and filled 2100 prescriptions (mean 5.5 prescriptions per year among infants taking medications). Most visits were non-well child care visits to pediatric primary care providers. Prematurity and bronchopulmonary dysplasia (BPD) are important risk factors: infants at 23 to 26 weeks gestation or infants with BPD had an average 29 visits per year and 9 prescriptions per year among infants taking medication. However, half of the highest using infants were relatively healthy infants at 27 to 32 weeks gestation who escaped BPD, NEC or grade 3 to 4 intraventricular hemorrhage.Conclusion: Premature infants had frequent pediatric visits and prescription medications. Extreme prematurity and neonatal morbidities are important risk factors; however, half of the highest using infants are moderately preterm without neonatal morbidities.

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“…Así, fue posible abordar un interrogante que ha generado controversia en los últimos años: ¿cuál es la mejor opción de tratamiento para los recién nacidos con déficit de surfactante, en quienes la opción de aplicarlo de manera suplementaria implica recurrir al soporte respiratorio con métodos invasivos o con alternativas no invasivas, pues esta conducta influye claramente en los resultados? (1,5,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Discussionunclassified

“…Otros beneficios de la CPAP fueron la menor incidencia de neumopatía crónica (17,8 Vs. 30,4 %), evaluada sin incluir a los fallecidos en los primeros 28 días de vida, así como la disminución de la gravedad de la displasia en el grupo tratado con CPAP.…”

Section: Discussionunclassified

Nasal CPAP vs. mechanical ventilation in 28-32 weeks preterm infants with early surfactant administration

et al. 2014

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Impact of Improved Survival of Very Low-Birth-Weight Infants on Incidence and Severity of Bronchopulmonary Dysplasia

Cited by 43 publications

References 22 publications

Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso

Displasia broncopulmonar: incidência, fatores de risco e utilização de recursos em uma população sul-americana de recém-nascidos de muito baixo peso

Pediatric care for preterm infants after NICU discharge: high number of office visits and prescription medications

Nasal CPAP vs. mechanical ventilation in 28-32 weeks preterm infants with early surfactant administration

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