Pulmonary phenotypes of bronchopulmonary dysplasia in the preterm infant

Prevalence, Prevention and Management of Bronchopulmonary Dysplasia

“…Within the population of infants meeting criteria for BPD, there exist several, often overlapping, clinical phenotypes that are differentially associated with adverse outcomes. 58,60,61 Impairment of alveolar development that leads to a paucity of abnormally distended airspaces typically presents with impairment of gas exchange and prolonged dependency on supplemental O 2 . 60,61 BPD-PH affects up to 25% of infants with moderate-to-severe BPD 62 and is associated with both increased morbidity and mortality.…”

“…58,60,61 Impairment of alveolar development that leads to a paucity of abnormally distended airspaces typically presents with impairment of gas exchange and prolonged dependency on supplemental O 2 . 60,61 BPD-PH affects up to 25% of infants with moderate-to-severe BPD 62 and is associated with both increased morbidity and mortality. 58,62 Prolonged exposure to invasive positive pressure can disrupt normal central airway development, leading to varying degrees of tracheomalacia, bronchomalacia and tracheomegaly.…”

“…58 Other clinical phenotypes that have been described include interstitial lung disease and peripheral airway involvement that is associated with increased airway resistance and wheezing in later life. 57,60,61 Although the prevalence of symptomatic PPRD decreases after the first 3 years of life, studies continue to demonstrate that children and adults with BPD have reduced exercise tolerance, 64 lower quality of life scores, 65,66 increased airflow obstruction 67,68 and earlier decline in pulmonary function tests (PFTs). 67,69 An obstructive pattern of lung disease, characterized by a reduced functional expiratory volume in 1 sec (FEV 1 ) or a reduced ratio of FEV 1 to forced vital capacity (FVC) is the phenotype most frequently identified in pediatric and adult survivors of prematurity.…”