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The course of bronchopulmonary dysplasia. A radiographic follow-up
Insights
Long-term follow-up of premature infants with bronchopulmonary dysplasia (BPD) shows most pulmonary abnormalities resolve within 4-6 years. Early respiratory infections decreased as lung function improved.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Intermittent positive pressure ventilation is a common treatment for respiratory distress in neonates.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of low birth weight premature infants treated with intermittent positive pressure ventilation.
- To assess the resolution of bronchopulmonary dysplasia and the incidence of respiratory infections over a 4-6 year follow-up period.
Main Methods:
- Clinical follow-up and chest radiography were performed on 41 low birth weight premature infants.
- Infants received intermittent positive pressure ventilation during infancy.
Main Results:
- The abnormal chest patterns of bronchopulmonary dysplasia resolved or improved in most cases within 4-6 years, with resolution primarily occurring in the first 2 years.
- Mild BPD showed a higher tendency to heal. Residual changes, mainly interstitial fibrosis or hyperinflation, were slight.
- Lower respiratory tract infections were more frequent in the first 2 years, correlating with pulmonary abnormality severity, and decreased significantly thereafter.
Conclusions:
- Bronchopulmonary dysplasia in low birth weight premature infants treated with intermittent positive pressure ventilation often shows significant resolution by 4-6 years of age.
- Early respiratory infection rates correlate with BPD severity but decrease as lung function improves over time.
Abstract:
Forty-one low weight premature infants treated with intermittent positive pressure ventilation in infancy were followed clinically and with chest radiography for 4 to 6 years. One child died during the period (sudden infantile death) and 2 others were not available for follow-up examination. The abnormal chest pattern of bronchopulmonary dysplasia (BPD) resolved completely or improved during the period; residual changes were found in 34 per cent of the cases. The main part of the resolution occurred during the first 2 years. Mild BPD was more prone to heal. The persisting parenchymal changes--interstitial fibrosis or areas of hyperinflation or both--were generally slight. The frequency of infection of the lower respiratory tract was increased during the first 2 years of life and was positively correlated to the severity of the pulmonary abnormalities. The frequency of infection dramatically decreased during the subsequent 2 years.