Development of lung function in very low birth weight infants with or without bronchopulmonary dysplasia: Longitudinal assessment during the first 15 months of corrected age

Gerd Schmalisch,Hans Proquitté,Charles Christoph Roehr,Christoph Bührer,Silke Wilitzki

doi:10.1186/1471-2431-12-37

Gerd Schmalisch, Hans Proquitté + Show 3 more

Open Access

https://doi.org/10.1186/1471-2431-12-37

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Journal: BMC Pediatrics	Publication Date: Mar 23, 2012
Citations: 96	License type: CC BY 2.0

Affiliation: Charité - Universitätsmedizin Berlin

Abstract

BackgroundVery low birth weight (VLBW) infants (< 1,500 g) with bronchopulmonary dysplasia (BPD) develop lung damage caused by mechanical ventilation and maturational arrest. We compared functional lung development after discharge from hospital between VLBW infants with and without BPD.MethodsComprehensive lung function assessment was performed at about 50, 70, and 100 weeks of postmenstrual age in 55 sedated VLBW infants (29 with former BPD [O2 supplementation was given at 36 weeks of gestational age] and 26 VLBW infants without BPD [controls]). Mean gestational age (26 vs. 29 weeks), birth weight (815 g vs. 1,125 g), and the proportion of infants requiring mechanical ventilation for ≥7 d (55% vs. 8%), differed significantly between BPD infants and controls.ResultsBoth body weight and length, determined over time, were persistently lower in former BPD infants compared to controls, but no significant between-group differences were noted in respiratory rate, respiratory or airway resistance, functional residual capacity as determined by body plethysmography (FRCpleth), maximal expiratory flow at the FRC (V'max FRC), or blood gas (pO2, pCO2) levels. Tidal volume, minute ventilation, respiratory compliance, and FRC determined by SF6 multiple breath washout (representing the lung volume in actual communication with the airways) were significantly lower in former BPD infants compared to controls. However, these differences became non-significant after normalization to body weight.ConclusionsAlthough somatic growth and the development of some lung functional parameters lag in former BPD infants, the lung function of such infants appears to develop in line with that of non-BPD infants when a body weight correction is applied. Longitudinal lung function testing of preterm infants after discharge from hospital may help to identify former BPD infants at risk of incomplete recovery of respiratory function; such infants are at risk of later respiratory problems.

Highlights

Very low birth weight (VLBW) infants (< 1,500 g) with bronchopulmonary dysplasia (BPD) develop lung damage caused by mechanical ventilation and maturational arrest
The effect of BPD on development of lung function parameters was explored by multivariate analysis of variance (MANOVA); gestational age and birth weight were used as covariates
Significant p-values are shown in bold 1) Total number is reduced because the some data of outpatients were incomplete lower gestational age and birth weight; the proportion of such infants that had an extremely low birth weight (< 1,000 g) was almost 3-fold higher than in the control group

Summary

Introduction

Very low birth weight (VLBW) infants (< 1,500 g) with bronchopulmonary dysplasia (BPD) develop lung damage caused by mechanical ventilation and maturational arrest. A considerable body of data has revealed that very preterm infants with “new BPD” exhibit abnormalities in lung function after birth [10,11,12], during the first years of life [13,14,15,16,17], throughout childhood [7,18,19,20,21,22,23], and into early adolescence [24] It is currently unclear whether survivors of BPD are at increased risk of developing a later COPD-like phenotype [25]. The aim of the present longitudinal study was to compare the development of lung function and somatic growth in very preterm infants with and without BPD during the first 15 months of corrected age

Methods

Results

Conclusion