The Association between Early Tracheal Colonization and Bronchopulmonary Dysplasia

Young, Karen; Moral, Teresa Del; Claure, Nelson; Vanbuskirk, Silvia; Bancalari, Eduardo

doi:10.1038/sj.jp.7211297

Cited by 32 publications

(14 citation statements)

References 19 publications

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“…The process of intubation not only increases the chances of hemodynamic instability [29] but also bridges the unsterile upper airway to that of the lower airway leading to increased incidence of colonization and infection of the lower airways and lungs causing lung injury [30]. Positive-pressure ventilation also causes trauma to the lungs by multiple mechanisms such as barotrauma, volutrauma, atelectrauma, and biotrauma [31].…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

Rastogi

Rajasekhar

Gupta

et al. 2012

International Journal of Pediatrics

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Objective. Identification of the weight and postmenstrual age (PMA) at successful weaning of NCPAP in preterm neonates and the factors influencing the successful wean. Study Design. Retrospective review of 454 neonates ≤32 weeks of gestational age (GA) who were placed on NCPAP and successfully weaned to room air was performed. Results. Neonates had a mean birth weight (BW) of 1357 ± 392 grams with a mean GA of 29.3 ± 2.2 weeks. Neonates were weaned off NCPAP at mean weight of 1611 ± 432 grams and mean PMA of 32.9 ± 2.4 weeks. Univariate analysis showed that chorioamnionitis, intubation, surfactant use, PDA, sepsis/NEC, anemia, apnea, GER and IVH were significantly associated with the time to NCPAP wean. On multivariate analysis, among neonates that were intubated, BW was the only significant factor (P < 0.001) that was inversely related to time to successful NCPAP wean. Amongst non-intubated neonates, along with BW (P < 0.01), chorioamnionitis (P < 0.01), anemia (P < 0.0001), and GER (P < 0.02) played a significant role in weaning from NCPAP. Conclusion. Neonates were weaned off NCPAP at mean weight of 1611 ± 432 grams and mean PMA of 32.9 ± 2.4 weeks. BW significantly affects weaning among intubated and non-intubated neonates, though in neonates who were never intubated chorioamnionitis, anemia and GER also significantly affected the duration on NCPAP.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

Rastogi

Rajasekhar

Gupta

et al. 2012

International Journal of Pediatrics

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“…While the association between inflammation and BPD is clear (Speer, 2003; Willet et al, 2001; Young et al, 2005), the molecular mechanisms explaining how lung development is arrested have not been identified. Inflammation may disrupt lung formation by altering growth factor expression and epithelial differentiation (Benjamin et al, 2007; Kramer et al, 2008; Prince et al, 2004), each potentially contributing to BPD.…”

Section: Discussionmentioning

confidence: 99%

The role of integrin α8β1 in fetal lung morphogenesis and injury

Benjamin

Gaston²,

Halloran³

et al. 2009

Developmental Biology

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Prenatal inflammation prevents normal lung morphogenesis and leads to bronchopulmonary dysplasia (BPD), a common complication of preterm birth. We previously demonstrated in a bacterial endotoxin mouse model of BPD that disrupting fibronectin localization in the fetal lung mesenchyme causes arrested saccular airway branching. In this study we show that expression of the fibronectin receptor, integrin α8β1, is decreased in the lung mesenchyme in the same inflammation model suggesting it is required for normal lung development. We verified a role for integrin α8β1 in lung development using integrin α8-null mice, which develop fusion of the medial and caudal lobes as well as abnormalities in airway division. We further show in vivo and vitro that α8-null fetal lung mesenchymal cells fail to form stable adhesions and have increased migration. Thus we propose that integrin α8β1 plays a critical role in lung morphogenesis by regulating mesenchymal cell adhesion and migration. Furthermore, our data suggests that disruption of the interactions between extracellular matrix and integrin α8β1 may contribute to the pathogenesis of BPD.

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“…Elevated cord blood IL-6 was also associated with chorioamnionitis and with longer postnatal oxygen therapy [138]. Young et al [139] studied 308 infants with birth weights 500 to 1,000 g, who were intubated by day 1, to examine the correlations among chorioamnionitis, initial TA culture results, and BPD28 and BPD36. They found that there was an association between chorioamnionitis and both BPD28 and BPD36, and also an association with an initial positive tracheal culture and BPD infants born at 700-1,000 g. As previously discussed, the chemokines MCP-1, 2, 3, and MIP-1α, β are elevated in TA in the first week from ventilated infants who develop BPD, and MIP-1α and MIP-1β were associated with histologic chorioamnionitis and TA isolation of Ureaplasma urealyticum [93].…”

Section: In Utero Inflammationmentioning

confidence: 98%

Inflammatory Mediators in the Immunobiology of Bronchopulmonary Dysplasia

Ryan

Ahmed

Lakshminrusimha

2007

Clinic Rev Allerg Immunol

111

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Inflammation is important in the development of bronchopulmonary dysplasia (BPD). Polymorphonuclear cells and macrophages and proinflammatory cytokines/chemokines denote early inflammation in clinical scenarios such as in utero inflammation with chorioamnionitis or initial lung injury associated with respiratory distress syndrome or ventilator-induced lung injury. The persistence and non-resolution of lung inflammation contributes greatly to BPD, including altering the lung's ability to repair, contributing to fibrosis, and inhibiting secondary septation, alveolarization, and normal vascular development. Further understanding of the role of inflammation in the pathogenesis of BPD, in particular, during the chronic inflammatory period, offers us the opportunity to develop inflammation-related prevention and treatment strategies of this disease that has long-standing consequences for very premature infants.

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The Association between Early Tracheal Colonization and Bronchopulmonary Dysplasia

Abstract: Preterm infants exposed to chorioamnionitis have an increased incidence of early tracheal colonization. This early tracheal colonization may predispose them to develop BPD.

Cited by 32 publications

References 19 publications

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

Factors Affecting the Weaning from Nasal CPAP in Preterm Neonates

The role of integrin α8β1 in fetal lung morphogenesis and injury

Inflammatory Mediators in the Immunobiology of Bronchopulmonary Dysplasia

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