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Improving pulmonary function does not decrease oxygen consumption in infants with bronchopulmonary dysplasia
L C Kao1, D J Durand, B G Nickerson
1Division of Neonatology, Children's Hospital, Oakland, California 94609.
Insights
High oxygen consumption in infants with bronchopulmonary dysplasia (BPD) is not caused by increased breathing effort. Treatments improved breathing mechanics but did not lower oxygen consumption in these infants.
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Infants with bronchopulmonary dysplasia (BPD) often exhibit high oxygen consumption (VO2).
- The underlying cause of elevated VO2 in BPD, particularly its relationship to breathing mechanics, requires further investigation.
Purpose of the Study:
- To investigate if increased mechanical power of breathing contributes to high VO2 in infants with BPD.
- To assess if improving pulmonary mechanics reduces mechanical power of breathing and VO2 in these infants.
Main Methods:
- A study involving 16 infants with oxygen-dependent BPD.
- Measurements included pulmonary mechanics, mechanical power of breathing, and VO2 before and after interventions (placebo, theophylline, diuretics, or theophylline plus diuretics).
Main Results:
- Infants with BPD demonstrated elevated VO2, increased airway resistance, decreased dynamic compliance, and increased mechanical power of breathing.
- Treatment interventions significantly improved pulmonary mechanics and reduced the mechanical power of breathing.
- However, none of the treatments led to a significant reduction in VO2.
Conclusions:
- The increased oxygen consumption (VO2) in infants with bronchopulmonary dysplasia (BPD) is likely not a direct consequence of increased mechanical power of breathing.
- Therapeutic improvements in pulmonary mechanics do not necessarily translate to reduced VO2 in this population.
Abstract:
To determine whether the high oxygen consumption VO2 in infants with bronchopulmonary dysplasia (BPD) is caused by increased mechanical power of breathing, and if improvement of pulmonary mechanics would reduce mechanical power of breathing and VO2 we gave 16 infants with oxygen-dependent BPD at 19.5 +/- 10.7 (mean +/- SD) weeks of age placebo, theophylline, and orally administered diuretics or theophylline plus diuretics. Pulmonary mechanics, mechanical power of breathing, and VO2 were measured at the beginning and end of each study period. In the placebo group, all infants had elevated VO2 (7.4 +/- 1.4 mL/kg/min) and carbon dioxide production (6.6 +/- 1.2 mL/kg/min), increased airway resistance (59 +/- 30 cm H2O/L/sec), decreased dynamic compliance (0.073 +/- 0.024 mL/cm H2O/cm), increase respiratory rate (52 +/- 11), and increased mechanical power of breathing (2.22 +/- 1.05 kg.cm/kg/min). Treatment with theophylline, diuretics, and theophylline plus diuretics resulted in a significant improvement in pulmonary mechanics and mechanical power of breathing, but not in VO2. These results suggest that the increased VO2 in infants with BPD is not secondary to increased mechanical power of breathing.