Risk For Development Of Bronchopulmonary Dysplasia Research Articles

The role of fibroblast growth factor-2 in the development of bronchopulmonary dysplasia in very and extremely low birth weight infants

Introduction and objective: The aim of the study was to assess the association between serum levels of fibroblast growth factor-2 (FGF-2) in infants in the first week of life and the risk of developing bronchopulmonary dysplasia. Materials and methods: The study included 103 infants, born before 32 weeks of gestation with a birth weight ≤1,500 g. Serum FGF-2 levels were measured in all newborns on days 1 and 7 of life. Results: Analysing the dynamics of changes in serum FGF-2 level, a statistically significant positive correlation was observed for birth weight (R = 0.20, p = 0.0423) in the first week of life. However, no statistically significant correlation was found for gestational age (R = 0.06, p = 0.5146). Infants with bronchopulmonary dysplasia had significantly lower gestational age than those without bronchopulmonary dysplasia (p < 0.0001) and birth weight (p < 0.0001). No statistically significant correlation was found between the dynamics of changes in serum FGF-2 level in the first week of life and the risk of bronchopulmonary dysplasia development for the definition of bronchopulmonary dysplasia on day 28 of life (p = 0.5330), and for the definition as the need for supplemental oxygen and/or respiratory support at 36 weeks of postmenstrual age (p = 0.7914). Conclusions: The study found no association between the serum FGF-2 level in the first week of life and the risk of bronchopulmonary dysplasia development in infants born before 32 weeks of gestation with a birth weight ≤1,500 g. In the study group, a statistically significant positive correlation was found for birth weight. In our study, gestational age and birth weight were found to be among the major risk factors for the development of bronchopulmonary dysplasia.

Surfactant delivery strategies to prevent bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is one of the most devastating morbidities of preterm infants. Antenatal factors like growth restriction and inflammation are risk factors for its development. Use of oxygen and positive pressure ventilation, which are often necessary to treat respiratory distress syndrome (RDS), increase the risk for development of BPD. Continuous positive airway pressure (CPAP) as primary respiratory support allows for avoidance of positive pressure ventilation in many cases but may lead to a delay of surfactant administration which is a proven therapy for RDS. Several alternative surfactant delivery strategies, including nebulization of surfactant, pharyngeal instillation of surfactant, delivery of surfactant via supraglottic airway device or surfactant delivery via a thin endotracheal catheter have been described which allow for the benefit of surfactant therapy while on CPAP. This review reports available data and discusses the existing evidence of their value in preventing BPD as well as further research directions.

Treatment and prophylaxis of moderate and severe bronchopulmonary dysplasia in premature neonates

Bronchopulmonary dysplasia in premature neonates leads to physical and mental developmental disorders and behavioral problems and associated with frequent rehospitalizations and long hospital stay. Study objective: to study the predictors of bronchopulmonary dysplasia development in premature neonates in structure of intensive care. Study design: A retrospective cohort analysis was performed in 127 children recruited from two NICU of Dnipro between January 2016 to March 2020. Inclusion criteria: preterm neonates 28-32 gestation weeks with respiratory distress syndrome (RDS). Results demonstrated that every day of mechanical ventilation, supplemental oxygen with FiO2 more than 30% and cardiac drugs usage increased risk of bronchopulmonary dysplasia development by 15-20%. In conclusion, finding out predictors of bronchopulmonary dysplasia helps to improve and prudently use usual treatment regimens in premature neonates and decrease the frequency of moderate and severe bronchopulmonary dysplasia.

Abstract 14661: Early Predictive Markers of Right Ventricular - Pulmonary Vascular Dysfunction in Preterm Infants With Bronchopulmonary Dysplasia

Introduction: Improved survival of extremely preterm infants has led to an increased recognition of bronchopulmonary dysplasia (BPD) associated with abnormal cardio-pulmonary hemodynamics. Reliable non-invasive quantitative markers for early recognition of BPD in preterm infants are lacking. The aim of this study was to evaluate quantitative echocardiographic measures of right ventricular hemodynamics (RV) as early predictive markers in infants at risk for development of BPD. Methods: A prospective study was conducted in 115 preterm infants (< 29 weeks gestational age) enrolled through the Prematurity and Respiratory Outcomes Program (NCT01435187). Echocardiographic measures of RV function and pulmonary hemodynamics were evaluated at 32 and 36 weeks post-menstrual age (PMA). RV systolic function was assessed with fractional area of change (FAC), tricuspid annular plane systolic excursion (TAPSE), and global and free wall longitudinal strain. RV morphometrics were assessed with RV dimensions and areas. Pulmonary hemodynamics were assessed by pulmonary artery acceleration time (PAAT). Commonly used qualitative measures (tricuspid regurgitation velocity and septal flattening) were evaluated for comparison. BPD was classified by the NIH workshop definition. Results: RV global and free wall strain, FAC, TAPSE, and PAAT were significantly reduced, and RV morphometrics were significantly larger at 32 and 36 weeks PMA in preterm infants who developed BPD (Table 1). Qualitative measures were present in < 20% of patients, and only septal flattening was significant at 32 weeks PMA in the BPD group. Conclusions: Quantitative echocardiographic measures of RV function and pulmonary hemodynamics are reliable early predictive markers of subsequent development of BPD in preterm infants. These measures are superior to commonly used qualitative measures and can be useful tools for early identification of preterm infants at high risk for BPD.