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Impact of chest radiography-based definition of bronchopulmonary dysplasia

Hirokazu Arai1, Tomoo Ito1, Masato Ito2

  • 1Department of Neonatology, Akita Red Cross Hospital, Akita, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|January 14, 2019
PubMed

Insights

Bubbly/cystic lung patterns in extremely preterm infants predict worse respiratory outcomes and need for home oxygen therapy. This early indicator aids in managing bronchopulmonary dysplasia (BPD28).

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Medical Imaging

Background:

  • Bubbly/cystic lung patterns on chest radiographs are linked to severe bronchopulmonary dysplasia (BPD) in Japan.
  • Bronchopulmonary dysplasia diagnosed at 28 days (BPD28) is a critical concern in extremely preterm infants.
  • Understanding perinatal factors and neonatal complications associated with these radiographic patterns is essential.

Purpose of the Study:

  • To investigate the perinatal characteristics and neonatal complications in extremely preterm infants with BPD28 exhibiting bubbly/cystic lung patterns.
  • To compare outcomes between infants with and without bubbly/cystic radiographic findings.

Main Methods:

  • A multicenter retrospective cohort study using data from the Neonatal Research Network of Japan.
  • Inclusion criteria: infants with birthweight <1,500g, born <28 weeks' gestational age (GA).
  • Classification of 8,979 infants meeting BPD28 criteria based on bubbly/cystic appearance on radiographs after 28 postnatal days.

Main Results:

  • Infants with bubbly/cystic patterns (bubbly/cystic(+)) had significantly lower GA and birthweight.
  • The bubbly/cystic(+) group required longer mechanical ventilation and oxygen dependency.
  • Bubbly/cystic appearance was an independent risk factor for requiring home oxygen therapy at discharge.

Conclusions:

  • Bubbly/cystic lung patterns on chest radiographs are a predictor of short-term respiratory outcomes in BPD28.
  • This radiographic finding may indicate a distinct etiology compared to later-diagnosed BPD (BPD36).
  • Early identification of bubbly/cystic patterns can inform clinical management and prognostication for preterm infants.
Abstract

Keywords:
bronchopulmonary dysplasiachronic lung diseasedefinitionradiographic appearance

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