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Blunted peripheral chemoreceptor response to hyperoxia in a group of infants with bronchopulmonary dysplasia
M Katz-Salamon1, B Jonsson, H Lagercrantz
1Neonatal Unit, Department of Woman and Child Health, Karolinska Hospital, Stockholm, Sweden.
Insights
Many infants with bronchopulmonary dysplasia (BPD) have impaired peripheral chemoreceptor function, impacting their response to oxygen. This dysfunction is linked to BPD severity and ventilation duration.
Area of Science:
- Neonatology
- Respiratory Physiology
- Pediatric Pulmonology
Background:
- Infants with bronchopulmonary dysplasia (BPD) frequently experience chronic hypoxia.
- Supplemental oxygen (O2) use in BPD may alter peripheral chemoreceptor sensitivity.
Purpose of the Study:
- To assess peripheral chemoreceptor function in infants with BPD.
- To compare chemoreceptor response in BPD infants versus healthy preterm infants.
Main Methods:
- Utilized the hyperoxic test to evaluate peripheral chemoreceptor function.
- Compared 25 BPD infants with 35 preterm infants without BPD at 40 weeks postconceptional age.
Main Results:
- 60% of BPD infants lacked a hyperoxic response, compared to 20% of controls.
- Chemoreceptor response intensity correlated negatively with ventilator time and positively with time off oxygen.
- No ventilatory response to hyperoxia was observed in infants with severe BPD (grade 3).
- BPD infants required significantly longer to increase oxygen saturation.
Conclusions:
- Many infants with BPD exhibit abnormal peripheral chemoreceptor function.
- Severe BPD is associated with particularly impaired chemoreceptor responsiveness.
- Peripheral chemoreceptor dysfunction may contribute to respiratory instability in BPD.
Abstract:
Infants with BPD often suffer from chronic hypoxia and require supplemental oxygen (O2). This might affect the sensitivity of peripheral chemoreceptors. Therefore, we assessed peripheral chemoreceptor function in 25 infants with bronchopulmonary dysplasia (BPD) of varying severity, using the hyperoxic test. These infants were compared with 35 preterm infants who did not develop BPD. All infants were tested during the 40th week of postconceptional age and their mean postnatal age was 81.5 +/- 16.3 days. Sixty percent (15/25) of the BPD infants lacked a hyperoxic response, while the proportion of nonresponders to O2 among the other groups was 20% (7/35). The intensity of this response was negatively correlated to time spent on a ventilator and positively to time without supplemental oxygen. The intensity of chemoreceptor function was closely related to the severity of BPD; none of the infants with the most severe form of BPD (grade 3) showed a ventilatory response to hyperoxia. Furthermore, infants with BPD needed significantly longer time to increase their saturation than did non-BPD infants (4.7 and 9.3 sec, respectively). We conclude that many infants with BPD, particularly those with the most severe form of the disease, have abnormally functioning peripheral chemoreceptors.