Respiratory Morbidity and Lung Function Analysis During the First 36 Months of Life in Infants With Bronchopulmonary Dysplasia (BPD).

Dandan Chen,Xiaoli Zhu,Xueping Zhu,Xiaoqian Chen,Mingling Cui,Ningxun Cui,Jing Chen

doi:10.3389/fped.2019.00540

Abstract

Purpose: To explore the lung function of bronchopulmonary dysplasia (BPD) in premature infants to guide clinical prevention, early diagnosis and treatment.Methods: Thirty infants with BPD at 4–36 months of corrected gestational age were enrolled and divided into mild BPD and moderate and severe BPD groups. Thirty full-term healthy infants, and 30 non-BPD infants at 4–36 months of corrected gestational age were included as controls. Clinical information, including respiratory infections and re-hospitalization, was compared among these groups. Furthermore, lung function analysis was performed in the infants.Results: The upper respiratory tract infection rate and re-hospitalization rate were significantly higher in the infants with BPD than in the non-BPD infants. The tidal volume/kg, proportion of time to reach peak tidal expiratory flow/total expiratory time, tidal volume exhaled at peak tidal expiratory flow/total tidal volume in BPD group were significantly lower in the BPD group than those in non-BPD group. These values gradually decreased as the severity of BPD increased. The respiratory rate (RR) in BPD group was significantly higher than that in non-BPD group. As the severity of the BPD increased, slope of the descending branch of expiration of tidal breathing flow capacity ring (TBFVL) increased.Conclusion: There is a correlation between the severity of BPD and a poor prognosis of respiratory system. TBFVL can directly reflect the characteristics of Tidal Pulmonary Function in children with different degrees of BPD.

Highlights

Bronchopulmonary dysplasia (BPD) is the most serious respiratory disorder that is observed in premature infants
There has been a decrease in the rate that other adverse outcomes are observed in preterm infants, the rate of respiratory diseases that are associated with preterm birth has not declined
Compared with the results in the non-BPD group, the lung function parameters, including tidal volume per kg (VT/Kg), TPTEF/Te, and the fraction of tidal volume exhaled at peak tidal expiratory flow to total tidal volume (VPTEF/Ve), were lower in the BPD group (p < 0.05)

Summary

Introduction

Bronchopulmonary dysplasia (BPD) is the most serious respiratory disorder that is observed in premature infants. The term BPD more commonly refers to light BPD ( known as “new” BPD). This definition was adopted by the National Institute of Child Health and Human Development in June of 2001 (2). Light BPD mainly occurs in the immature lung of extremely premature babies without symptoms of respiratory distress syndrome (RDS) or with mild symptoms after birth. In these cases, oxygen delivery is not usually required, or there is only a need for a low concentration of oxygen and oxygen dependence gradually appears during hospitalization. There has been a decrease in the rate that other adverse outcomes are observed in preterm infants, the rate of respiratory diseases that are associated with preterm birth has not declined

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