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Bronchodilator responsiveness and dysanapsis in bronchopulmonary dysplasia

Leif D Nelin1,2, Matthew J Kielt1, Maria Jebbia1

  • 1Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Division of Neonatology, Dept of Pediatrics, The Ohio State University, Columbus, OH, USA.

ERJ Open Research
|July 7, 2022
PubMed

Insights

Infant pulmonary function test (iPFT) parameters can predict bronchodilator response in infants with bronchopulmonary dysplasia (BPD). Lower forced expiratory volume in 0.5 seconds (FEV0.5) and higher hyperinflation indicate a positive response.

Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) incidence is rising in preterm infants.
  • Bronchodilator use in BPD lacks strong evidence for guiding therapy.
  • Identifying predictors of bronchodilator response is crucial for optimizing BPD management.

Purpose of the Study:

  • To determine if infant pulmonary function test (iPFT) parameters can predict bronchodilator response in infants with BPD.
  • To investigate the relationship between baseline lung function and bronchodilator responsiveness.
  • To identify specific iPFT metrics associated with positive bronchodilator response.

Main Methods:

  • Analysis of iPFT data from 93 infants with BPD, including bronchodilator response.
  • Comparison of demographic and pulmonary function data between responders and non-responders.
  • Logistic regression modeling to identify significant predictors of bronchodilator response.

Main Results:

  • 63% of infants showed bronchodilator responsiveness.
  • Responders had lower forced expiratory volume in 0.5 seconds (FEV0.5) and FEV0.5/FVC ratios.
  • Responders exhibited greater indices of hyperinflation and smaller dysanapsis ratios compared to non-responders.
  • Pre-bronchodilator FEV0.5 and functional residual capacity/total lung capacity significantly predicted response.

Conclusions:

  • Specific iPFT parameters, including FEV0.5 and hyperinflation indices, predict bronchodilator response in infants with BPD.
  • Infants responding to bronchodilators demonstrated evidence of greater dysanaptic lung growth.
  • These findings can inform more targeted bronchodilator therapy in BPD.
Abstract

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