Abstract
“New” bronchopulmonary dysplasia (BPD) has been suggested to be a maldevelopment sequence with reduced alveolarisation of the lungs; affected infants then would be predicted to have low lung volumes. The aim of this study was to test that hypothesis by comparing the lung volumes of infants who had had mild-moderate BPD with those without BPD of similar postmenstrual age. Lung volumes of 17 infants who had mild-moderate BPD (oxygen dependent beyond 28 days, but not past term) (BPD infants) were compared to those of 17 infants without BPD (non-BPD infants). All were born at less than 33 weeks of gestation and studied at postmenstrual ages of 33 to 39 weeks. Lung volume was assessed by measurement of functional residual capacity (FRC). The BPD infants had lower lung volumes (median 19.1 ml/kg) than the non-BPD infants (median 26.5 ml/kg) (p=0.0001). The BPD compared to the non-BPD infants were of greater postnatal age (p=0.0003), born at a lower gestational age (p=0.0001) and of lighter birthweight (p=0.0001). Regression analysis, however, demonstrated that lung volume was significantly related to BPD status (p=0.005), independently of postnatal age, birthweight and gestational age. It is concluded that the lower lung volumes of the infants who had had mild-moderate BPD support the hypothesis that new BPD is associated with poor alveolarisation.
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Abbreviations
- BPD:
-
Bronchopulmonary dysplasia
- CPAP:
-
Continuous positive airway pressure
- FRC:
-
Functional residual capacity
- PMA:
-
Postmenstrual age
References
Bhat RY, Leipala JA, Singh NR, Rafferty GF, Hannam S, Greenough A (2003) Effect of posture on oxygenation, lung volume and respiratory mechanics in premature infants studied before discharge. Pediatrics 112:29–32
Coalson JJ, Winter V, deLemos RR (1995) Decreased alveolarisation in baboon survivors with bronchopulmonary dysplasia. Am J Respir Crit Care Med 152:640–6
Coalson JJ, Winter VV, Gertsmann DR, Idell S, King RJ, Delemos RA (1992) Pathophysiological morphometric and biochemical studies of the premature baboon with bronchopulmonary dysplasia. Am Rev Respir Dis 145:872–881
Dimitriou G, Greenough A (1995) Measurement of lung volume and optimal oxygenation during high frequency oscillation. Arch Dis Child 72:F180–183
Erickson AM, delaMonte SM, Moore GW, Hutchins GM (1987) The prognosis of morphologic changes in bronchopulmonary dysplasia. Am J Pathol 127:474–484
Greenough A, Alexander J, Burgess S, Chetcuti PA, Cox S, Lenney W, Turnbull F, Shaw NJ, Woods A, Boorman J, Coles S, Turner J (2002) Home oxygen status and rehospitalisation and primary care requirements of infants with chronic lung disease. Arch Dis Child 86:40–43
Hey EN (1969) The relation between environmental temperature and oxygen consumption in the newborn baby. J Physiol 200:589–603
Husain AN, Siddiqui NH, Stocker JT (1998) Pathology of arrested acinar development in postsurfactant bronchopulmonary dysplasia. Hum Pathol 29:710–717
Jobe AH, Bancalari E (2001) Bronchopulmonary dysplasia. NICHD-NHLBI-ORD workshop. Am J Respir Crit Care Med 163:1723–1729
Johnson AH, Peacock JL, Greenough A, Marlow N, Limb ES, Marston L, Calvert SA: United Kingdom Oscillation Study Group (2002) High frequency oscillatory ventilation for the prevention of chronic lung disease for prematurity. New Engl J Med 347:633–642
Kavvadia V, Greenough A, Dimitriou G, Hooper R (1999) Comparison of the effect of two fluid input regimens on perinatal lung function in ventilated infants of very low birthweight. Eur J Pediatr 158:917–922
Kavvadia V, Greenough A, Dimitriou G, Hooper R (2000) Randomised trial of fluid restriction in ventilation very low birthweight infants. Arch Dis Childhood 83:F91–96
Kavvadia V, Greenough A, Dimitriou G, Itakura Y (1998) Lung volume measurements in infants with and without chronic lung disease. Eur J Pediatr 157(4):336–339
Kinali M, Greenough A, Dimitriou G, Yuksel B, Hooper R (1999) Chronic respiratory morbidity following premature delivery—prediction of prolonged respiratory support requirement. Eur J Pediatr 158(6):493–496
Margraf LR, Tomashefski JF, Bruce MC, Dahms BB (1991) Morphometric analysis of the lungs in bronchopulmonary dysplasia. Am Rev Respir Dis 43:391–400
Shao H, Sandberg K, Hjalmarson O (1998) Impaired gas mixing and low lung volume in preterm infants with mild chronic lung disease. Pediatr Res 43:536–541
Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM (1988) Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics 82:527–532
Yüksel B, Greenough A, Chan V, Russell RR (1993) Comparison of helium dilution and nitrogen washout measurements of functional residual capacity in premature infants. Pediatr Pulmonol 16:197–200
Acknowledgements
Dr Jaana A Leipälä was supported by the Finish Medical Foundation, Drs Dimitriou and Broughton by the Wellchild Trust and Dr Bhat by the Joint Research Committee of King’s College Hospital. We thank Mrs Deirdre Gibbons for secretarial assistance.
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Greenough, A., Dimitriou, G., Bhat, R.Y. et al. Lung volumes in infants who had mild to moderate bronchopulmonary dysplasia. Eur J Pediatr 164, 583–586 (2005). https://doi.org/10.1007/s00431-005-1706-z
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DOI: https://doi.org/10.1007/s00431-005-1706-z