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Potential of early chest roentgen examination in ventilator treated newborn infants to predict future lung function
W Mortensson1, B Andréasson, M Lindroth
1Department of Diagnostic Radiology, St. Göran's Children's Hospital, Stockholm, Sweden.
Insights
Early chest X-rays in preterm infants treated with ventilators can predict future lung function abnormalities. Findings like hyperinflation on early X-rays correlate with increased risk of airway obstruction and lung damage at follow-up.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Radiology
Background:
- Preterm infants often require mechanical ventilation, increasing their risk of developing chronic lung disease.
- Early identification of lung damage is crucial for timely intervention and improved long-term outcomes.
- The predictive value of early chest radiography in this population requires further investigation.
Purpose of the Study:
- To prospectively evaluate the potential of early chest X-ray findings to predict lung function abnormalities in preterm infants.
- To assess the correlation between early radiographic signs of lung damage and long-term respiratory outcomes at 8-10 years of age.
Main Methods:
- A prospective study involving 40 preterm infants treated with ventilators.
- Chest X-rays were performed 3-10 days post-ventilator treatment, categorizing infants into three groups based on findings (normal, interstitial abnormalities, or interstitial abnormalities with hyperinflation).
- Long-term follow-up included lung function tests and chest X-rays at 8-10 years of age.
Main Results:
- A significant correlation was observed between early chest X-ray findings and the risk of abnormal lung function at follow-up.
- Infants with focal or general hyperinflation on early X-rays showed a greater risk of developing airway obstruction.
- Those with only interstitial abnormalities faced a higher risk of general hyperinflation and increased airway obstruction compared to infants with normal early X-rays.
Conclusions:
- Early chest X-ray findings in preterm, ventilator-treated infants can serve as a valuable tool for predicting long-term lung function abnormalities.
- Radiographic signs of hyperinflation and interstitial abnormalities are associated with an increased risk of airway obstruction and chronic lung disease.
- These findings support the use of early chest radiography for risk stratification and management planning in high-risk preterm infants.
Abstract:
The potentially of early chest X-ray to predict the risk of lung function abnormalities was studied prospectively in 40 preterm ventilator treated infants in a 8-10-year follow-up investigation. According to the findings at chest X-ray 3 to 10 days after completed ventilator treatment the infants were divided into 3 groups considered to represent increasing risk and severity of lung damage: 1) normal findings, 2) interstitial parenchymal abnormalities exclusively or 3) in combination with local or general hyperinflation. Lung function tests and chest x-ray were performed at the age of 8 to 10 years. A correlation was found between the findings at the early chest roentgen examination and the risk of abnormal lung function at the follow-up. Occurrence of focal or general hyperinflation or both were associated with a greater risk of airway obstruction. Infants with only interstitial abnormalities were, however, at a higher risk than those with normal chest examination to develop general hyperinflation and increased air way obstruction.