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Long-term pulmonary sequelae of severe bronchopulmonary dysplasia
S V Jacob1, A L Coates, L C Lands
1Division of Respiratory Medicine, McGill University Montreal Children's Hospital-Research Institute, Quebec, Canada.
Insights
Severe bronchopulmonary dysplasia (BPD) can lead to lasting lung function problems in children. Survivors requiring prolonged oxygen may experience significant airflow limitation and gas trapping, impacting their respiratory health long-term.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
- Severe BPD, requiring prolonged supplemental oxygen, poses risks for long-term respiratory sequelae.
Purpose of the Study:
- To assess the long-term pulmonary function in survivors of severe bronchopulmonary dysplasia.
- To identify the extent of pulmonary sequelae in children requiring significant oxygen support post-term.
Main Methods:
- A cohort of 15 patients with severe BPD (oxygen >1 month post-term) was studied.
- Pulmonary function tests (spirometry, lung volumes, diffusion capacity, static elastic recoil pressures) were performed.
- Patients were matched to preterm infants without BPD for comparison.
Main Results:
- BPD survivors exhibited significantly reduced expiratory volume in 1 second (FEV1) (64% vs. 85% predicted, P < .01).
- Increased gas trapping was observed in BPD survivors (residual volume/total lung capacity ratio 37% vs. 25%, P < .01).
- A strong inverse correlation was found between FEV1 and duration of supplemental oxygen (r = -0.84, P < .0001).
Conclusions:
- Severe BPD is associated with moderate to severe long-term pulmonary function abnormalities.
- Prolonged oxygen requirement in BPD correlates with worse airflow limitation and gas trapping.
- These findings highlight the lasting impact of severe BPD on lung health.
Objective:
To evaluate the long-term pulmonary sequelae of survivors of bronchopulmonary dysplasia (BPD) of sufficient severity to have required supplemental oxygen for at least 1 month after term.
Study Design:
Fifteen patients with a mean age of 1.1 years were matched to preterm infants of similar gestational age and age at time of study. Pulmonary function testing included spirometry, plethysmographic lung volumes, carbon monoxide diffusion capacity, and in 9 of 15 subjects with BPD, measurement of lung static elastic recoil pressures.
Results:
The subjects with BPD had a mean expiratory volume in 1 second (FEV1) of 64% +/- 21% predicted (4 had an FEV1 < 50% predicted) compared with 85% +/- 11% (P < .01) for the preterm children in the control group. Subjects with BPD had a significant degree of gas trapping with a residual volume to total lung capacity ratio of 37% +/- 13% compared with 25% +/- 4% for the control group (P < .01). An inverse relationship was seen between the FEV1 and the time on supplemental oxygen (r = -0.84, P < .0001), with 3 of the 4 children whose FEV1 was < 50% requiring oxygen for more than 900 days. Those with the greatest degree of airflow limitation and gas trapping had the greatest abnormalities in both shape and position of the pressure volume curves of the lung.
Conclusion:
Severe BPD may result in moderate to severe long-term abnormalities in pulmonary function tests.