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Persistent acquired lobar overinflation complicating bronchopulmonary dysplasia
C Murray1, D W Pilling, N J Shaw
1Neonatal Unit, Liverpool Women's Hospital, UK.
European Journal of Pediatrics
|February 1, 2000
Summary
Persistent acquired lobar overinflation (PALO) is a serious complication of bronchopulmonary dysplasia (BPD). This condition in infants has a poor prognosis, with many requiring intensive care and a high mortality rate.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Persistent acquired lobar overinflation (PALO) is a known complication of bronchopulmonary dysplasia (BPD).
- Infants with BPD often require significant ventilatory support for respiratory distress syndrome.
- Understanding PALO's impact on BPD outcomes is crucial for clinical management.
Purpose of the Study:
- To identify and characterize cases of PALO in infants with BPD.
- To describe the clinical course and outcomes of these patients.
- To evaluate the effectiveness of current therapeutic approaches.
Main Methods:
- Retrospective review of 11 infants with BPD and PALO.
- Data collection included gestational age, birth weight, ventilatory support duration, and age at PALO diagnosis.
- Outcomes assessed included re-admission rates, mortality, bronchoscopy findings, and ventilation-perfusion scans.
Main Results:
- Median gestational age was 29 weeks; median birth weight was 1317 g.
- Median duration of ventilatory support was 26 days.
- Nine patients required re-admission for respiratory deterioration; six died by a median age of 9.5 months.
- Bronchomalacia was suggested in four of five bronchoscopies.
- Ventilation-perfusion scans showed no mismatch in the overinflated lobe.
Conclusions:
- The optimal therapy for PALO in BPD remains uncertain.
- Surgical intervention for PALO may be contraindicated.
- PALO is associated with a poor outcome in infants with BPD.