Related Experiment Video
Updated: Jun 27, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Chest radiograph thoracic areas and lung volumes in infants developing bronchopulmonary dysplasia
Caroline May1, Michael Prendergast, Saba Salman
1MRC-Asthma Centre, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
Insights
Infants who develop Bronchopulmonary Dysplasia (BPD) have lower lung volumes and potentially higher thoracic areas in the perinatal period. This suggests ventilation inhomogeneity in premature infants at risk for BPD.
Area of Science:
- Neonatal medicine
- Pediatric pulmonology
- Medical imaging
Background:
- Bronchopulmonary Dysplasia (BPD) is a significant complication in premature infants.
- Early identification of factors predicting BPD is crucial for timely intervention.
- Chest radiography (CXR) and lung function tests offer insights into respiratory health.
Purpose of the Study:
- To investigate differences in chest radiograph (CXR) thoracic areas and lung volumes between infants who developed BPD and those who did not.
- To analyze these differences based on the severity of BPD.
Main Methods:
- A prospective study involving 53 preterm infants (median gestational age 28 weeks).
- CXR thoracic areas were measured using PACS; lung volume assessed via functional residual capacity (FRC) within 72 hours of birth.
- BPD was categorized as mild or moderate/severe based on oxygen dependency at 36 weeks post-menstrual age (PMA).
Main Results:
- Infants who developed BPD (32/53) showed significantly higher median CXR thoracic areas and lower median FRCs compared to those without BPD.
- Moderate/severe BPD cases (21/32) exhibited significantly larger thoracic areas and lower FRCs than both no BPD and mild BPD groups.
- Mild BPD cases also had larger thoracic areas than the no BPD group.
Conclusions:
- Preterm infants who develop BPD, especially moderate/severe forms, exhibit reduced functional lung volumes in the perinatal period.
- Elevated thoracic areas in these infants may indicate gas trapping or altered lung development.
- These findings suggest ventilation inhomogeneity as a key factor in BPD development.
Objectives:
To determine whether chest radiograph (CXR) thoracic areas and lung volumes differed between infants who did and did not develop BPD and according to the severity of BPD developed.
Working Hypothesis:
Infants developing BPD, particularly if moderate or severe, would have low CXR thoracic areas and lung volumes in the perinatal period.
Study Design:
Prospective study. PATIENT-SUBJECT SELECTION: 53 infants with a median gestational age of 28 (range 24-32) weeks.
Methodology:
CXR thoracic areas were calculated using a Picture Archiving and Communicating System (PACS) and lung volume assessed by measurement of functional residual capacity (FRC) in the first 72 hr after birth. BPD was diagnosed if the infants were oxygen dependent beyond 28 days, mild BPD in infants no longer oxygen dependent at 36 weeks post-menstrual age (PMA) and moderate/severe BPD in infants who required supplementary oxygen with or without respiratory support at 36 weeks PMA.
Results:
Thirty two infants developed BPD, 21 had moderate/severe BPD. The median CXR thoracic areas were higher (P < 0.0001) and FRCs were lower (P < 0.0001) in the BPD compared to no BPD infants. The median CXR thoracic areas of the moderate/severe group (P < 0.001) and the mild group (P < 0.05) were greater than that of the no BPD group and the median FRC of the moderate/severe BPD group was lower than the no BPD group (<0.001) and the mild BPD group (P < 0.05).
Conclusion:
These results highlight that in the perinatal period infants developing BPD, particularly if moderate/severe, have low functional lung volumes and may have gas trapping, which likely reflects ventilation inhomogeneity.
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