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Obstructive lung disease in children with mild to severe BPD
Eva Berggren Broström1, Per Thunqvist, Gunilla Adenfelt
1Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Pediatrics, Stockholm, Sweden. eva.berggren-brostrom@karolinska.se
Respiratory Medicine
|November 13, 2009
Summary
Children with bronchopulmonary dysplasia (BPD) show impaired lung function and structural changes, regardless of severity. This suggests a risk for chronic obstructive pulmonary disease later in life.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a significant cause of respiratory insufficiency in extremely premature infants.
- Understanding long-term pulmonary outcomes in BPD survivors is crucial for clinical management.
Purpose of the Study:
- To assess the impact of BPD severity on school-aged pulmonary morbidity using spirometry and impulse oscillometry.
- To correlate lung function changes with High-Resolution Computed Tomography (HRCT) findings in children with BPD.
- To investigate the association between BPD and atopy.
Main Methods:
- A cohort of 60 very low birth weight (VLBW) infants, including 32 with BPD and 28 without, were followed to school age (6-8 years).
- Evaluations included spirometry, impulse oscillometry, thoracic HRCT, allergy skin testing, and questionnaires.
- BPD severity was categorized as mild, moderate, or severe.
Main Results:
- All children with BPD demonstrated impaired lung function, including abnormal reactance and reduced FEV1, irrespective of symptomatic status.
- The majority of BPD patients (19/26) exhibited abnormalities on HRCT, indicating structural lung changes.
- No significant association was found between BPD and atopy.
Conclusions:
- Mild BPD cases showed comparable respiratory mechanics and lung structural impairments to moderate BPD cases.
- Widespread peripheral airway involvement in BPD suggests a potential risk for developing chronic obstructive pulmonary disease (COPD) in adulthood.
- Early identification and management of BPD-related lung changes are essential for long-term respiratory health.
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