Abstract
BackgroundMorphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Although some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques.Methodology/Principal FindingsWe studied 127 infants with BPD, 58 preterm infants without BPD and 239 healthy term-born infants, at a matched post-conceptional age of 44 weeks during quiet natural sleep according to ATS/ERS standards. Lung function parameters measured were functional residual capacity (FRC) and ventilation inhomogeneity by multiple breath washout as well as tidal breathing parameters. Preterm infants with BPD had only marginally lower FRC (21.4 mL/kg) than preterm infants without BPD (23.4 mL/kg) and term-born infants (22.6 mL/kg), though there was no trend with disease severity. They also showed higher respiratory rates and lower ratios of time to peak expiratory flow and expiratory time (t PTEF/t E) than healthy preterm and term controls. These changes were related to disease severity. No differences were found for ventilation inhomogeneity.ConclusionsOur results suggest that preterm infants with BPD have a high capacity to maintain functional lung volume during natural sleep. The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process.
Highlights
Chronic lung disease of infancy remains one of the major complications in premature infants, with possible impact upon short- and long-term respiratory morbidity [1,2,3]
Our results suggest that preterm infants with bronchopulmonary dysplasia (BPD) have a high capacity to maintain functional lung volume during natural sleep
The alterations in breathing pattern with disease severity may reflect presence of adaptive mechanisms to cope with the disease process
Summary
Chronic lung disease of infancy remains one of the major complications in premature infants, with possible impact upon short- and long-term respiratory morbidity [1,2,3]. The immaturity of the lungs together with other factors such as inflammation, disturbed vascularisation, hyperoxia and volu- or barotrauma during treatment may lead to the clinical picture of bronchopulmonary dysplasia (BPD) [4,6] These morphological changes in BPD lungs have functional consequences on lung volume, ventilation homogeneity and mechanics of the respiratory system, as reviewed recently [7,8,9,10]. Morphological changes in preterm infants with bronchopulmonary dysplasia (BPD) have functional consequences on lung volume, ventilation inhomogeneity and respiratory mechanics. Some studies have shown lower lung volumes and increased ventilation inhomogeneity in BPD infants, conflicting results exist possibly due to differences in sedation and measurement techniques
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