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Pulmonary Gas Exchange Improves over the First Year in Preterm Infants with and without Bronchopulmonary Dysplasia

Y Jane Choi1,2, Benjamin Stoecklin2,3, Naomi R Hemy1

  • 1Telethon Kids Institute, Perth, Washington, Australia.

Neonatology
|February 16, 2021
PubMed

Insights

Pulmonary gas exchange significantly improves in preterm infants over their first year of life. Bronchopulmonary dysplasia in extremely preterm infants causes initial gas exchange deficits, which resolve by one year corrected age.

Area of Science:

  • Neonatology
  • Respiratory Physiology
  • Pediatric Pulmonology

Background:

  • The oxyhaemoglobin saturation (SpO2) versus inspired oxygen pressure (PIO2) curve shift is a key indicator of pulmonary gas exchange.
  • Prematurity and bronchopulmonary dysplasia (BPD) can impact neonatal respiratory function.

Purpose of the Study:

  • To evaluate the effects of prematurity and BPD on gas exchange and shunting in neonates.
  • To track the evolution of these parameters during the first year of life.

Main Methods:

  • Assessed shift and shunt in extremely preterm (EP) and very preterm (VP) infants at 36 weeks, 44 weeks postmenstrual age (PMA), and 1-year corrected postnatal age (cPNA).
  • Utilized paired SpO2/PIO2 measurements and generalized linear regression for longitudinal analysis.
  • Included term infants as a reference group at 44 weeks PMA.

Main Results:

  • A continuous decline in gas exchange shift was observed in EP and VP infants throughout the first year.
  • No significant difference in shift was found compared to term infants at 44 weeks PMA.
  • EP infants with BPD exhibited higher shift at 36 and 44 weeks PMA, but this difference normalized by 1-year cPNA.

Conclusions:

  • Prematurity alone does not impair gas exchange at 1-year corrected age in the absence of lung disease.
  • Pulmonary gas exchange shows significant improvement in all preterm infants during the first year.
  • Early gas exchange deficits in extremely preterm infants with BPD resolve over time.
Abstract

Keywords:
Bronchopulmonary dysplasiaGas exchangeInfantOxyhaemoglobin dissociation curvePrematureRespiratory function tests

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