Nebulized pentoxifylline in successful treatment of five premature neonates with bronchopulmonary dysplasia

Early prediction of bronchopulmonary dysplasia (BPD) may facilitate tailored management for neonates at risk. We investigated whether easily accessible flow data from a mechanical ventilator can predict BPD in neonates born extremely premature (EP).In a prospective population-based study of EP-born neonates, flow data were obtained from the ventilator during the first 48 h of life. Data were logged for >10 min and then converted to flow–volume loops using custom-made software. Tidal breathing parameters were calculated and averaged from ≥200 breath cycles, and data were compared between those who later developed moderate/severe and no/mild BPD.Of 33 neonates, 18 developed moderate/severe and 15 no/mild BPD. The groups did not differ in gestational age, surfactant treatment or ventilator settings. The infants who developed moderate/severe BPD had evidence of less airflow obstruction, significantly so for tidal expiratory flow at 50% of tidal expiratory volume (TEF50) expressed as a ratio of peak tidal expiratory flow (PTEF) (p=0.007). A compound model estimated by multiple logistic regression incorporating TEF50/PTEF, birthweight z-score and sex predicted moderate/severe BPD with good accuracy (area under the curve 0.893, 95% CI 0.735–0.973).This study suggests that flow data obtained from ventilators during the first hours of life may predict later BPD in premature neonates. Future and larger studies are needed to validate these findings and to determine their clinical usefulness.

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Serum activity of MMP-2 and MMP-9 and stromielisin-1 concentration as predictors in the pathogenesis of bronchopulmonary dysplasia in preterm neonates

Postępy Higieny i Medycyny Doświadczalnej ◽

10.5604/01.3001.0013.6295 ◽

2019 ◽

Vol 73 ◽

pp. 703-712

Author(s):

Sławomir Wątroba ◽

Joanna Kocot ◽

Jarosław Bryda ◽

Jacek Kurzepa

Keyword(s):

Bronchopulmonary Dysplasia ◽

Statistical Significance ◽

Venous Blood ◽

Gelatin Zymography ◽

Study Groups ◽

Preterm Neonates ◽

Premature Neonates ◽

Elevated Activity ◽

Group 2 ◽

Group 1

Aim: Bronchopulmonary dysplasia (BPD) is one of the most severe respiratory diseases, mainly related to premature neonates. Previous studies indicated the role of matrix metalloproteinases (MMPs) in the development of BPD. The aim of the study was to determine the relationship between MMP-2, MMP-3, MMP-9 with their tissue inhibitors (TIMP-1 TIMP-2) and BPD occurrence in premature neonates. Material/Methods: Eighty-one patients, divided into four study groups, numbered from 1 to 4, depending on gestational age (25–28; 29–32; 33–36; 37–40 weeks), were enrolled. Venous blood was collected between 5 and 7 days after birth. The activity of MMP-2 and MMP-9 were determined with usage of gelatin zymography, whereas MMP-3, TIMP-1 and TIMP-2 was determined using the immunoassay ELISA. Results: BPD was diagnosed in 50% of patients from group 1 and 11% from group 2. The increase of MMP-2 activity in Group 2, and a decrease in MMP-2/TIMP-2 ratio was noticed in Group 1 compared to Group 2 and 4. A significantly lower incidence of BPD in patients with higher (above the median) values for MMP-2/TIMP-2 (OR = 0.02, CI = 0.00 – 0.55; p <0.05) was noticed in Group 1. The decreased occurrence of BPD in patients with higher MMP-3 concentration, higher MMP-9 activity and the higher value of MMP-9/TIMP-1 did not reach statistical significance. Conclusions: It has been shown that elevated activity of collagenolytic enzyme in serum, especially MMP-2, may have the effect of decreasing the risk of bronchopulmonary dysplasia in premature neonates.

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Oxygen Saturation in Premature Neonates with Bronchopulmonary Dysplasia in a Hammock

Neonatology ◽

10.1159/000244143 ◽

1995 ◽

Vol 67 (1) ◽

pp. 54-58 ◽

Cited By ~ 5

Author(s):

Vincenzo Zanardo ◽

Daniele Trevisanuto ◽

Carlo Dani ◽

Michele Bottos ◽

Alberto Guglielmi ◽

...

Keyword(s):

Oxygen Saturation ◽

Bronchopulmonary Dysplasia ◽

Premature Neonates

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GSTP1 and CYP2B6 Genetic Polymorphisms and the Risk of Bronchopulmonary Dysplasia in Preterm Neonates

American Journal of Perinatology ◽

10.1055/s-0036-1597994 ◽

2017 ◽

Vol 34 (08) ◽

pp. 729-734 ◽

Cited By ~ 2

Author(s):

Sophia Zachaki ◽

Aggeliki Daraki ◽

Elena Polycarpou ◽

Chrysa Stavropoulou ◽

Kalliopi Manola ◽

...

Keyword(s):

Bronchopulmonary Dysplasia ◽

Small Sample Size ◽

Antioxidant Response ◽

Polymerase Chain Reaction Method ◽

Small Sample ◽

Detoxification Enzymes ◽

Extremely Low Birth Weight ◽

Preterm Neonates ◽

Low Birth Weight Infants ◽

Premature Neonates

Objectives Antioxidant response plays a key role in bronchopulmonary dysplasia (BPD) pathogenesis. The glutathione-S-tranferases pi 1 (GSTP1) and cytochrome P450 (CYP) detoxification enzymes protect cells from oxidative damage. The aim of the study was to investigate whether the A313G GSTP1 and G516T CYP2B6 inactivating polymorphisms could be associated with BPD susceptibility. Study Design To test this hypothesis, we conducted a case–control study enrolled 138 premature neonates ≤32 weeks of gestational age; of the 138, 46 developed BPD and 92 did not develop BPD. Genomic deoxyribonucleic acid was extracted from neonates' peripheral blood and was used as template for GSTP1 and CYP2B6 genotyping using the real-time polymerase chain reaction method. Results Our report provides evidence for a possible pathogenetic role of the G516T CYP2B6 polymorphism in BPD susceptibility. Although no differences in the frequencies of the GSTP1 variant genotypes were noticed between premature neonates who developed BPD and neonates who did not develop BPD, a significantly higher frequency of the GSTP1 polymorphism was observed in extremely low birth weight infants. Despite the small sample size, it is very interesting the fact that all neonates ≤1,000 g carrying the homozygous mutant GSTP1 genotype developed BPD. Conclusion Our results underscore the significance of both CYP2B6 and GSTP1 polymorphisms in modulating the risk of BPD.

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Analysis of interleukins 6, 8, 10 and 17 in the lungs of premature neonates with bronchopulmonary dysplasia

Cytokine ◽

10.1016/j.cyto.2020.155118 ◽

2020 ◽

Vol 131 ◽

pp. 155118

Author(s):

Sandra Mara Witkowski ◽

Eduardo Morais de Castro ◽

Seigo Nagashima ◽

Ana Paula Camargo Martins ◽

Cristina Terumy Okamoto ◽

...

Keyword(s):

Bronchopulmonary Dysplasia ◽

Premature Neonates

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Cross-risks of development of bronchopulmonary dysplasia and necrotizing enterocolitis of premature neonates

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-09 ◽

2020 ◽

Vol 24 (4) ◽

pp. 611-617

Author(s):

A. V. Bolonska ◽

O. Yu. Sorokina

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Necrotizing Enterocolitis ◽

Bronchopulmonary Dysplasia ◽

Distress Syndrome ◽

Fluid Intake ◽

Neurological Status ◽

Premature Baby ◽

Respiratory Support ◽

Premature Neonates

Annotation. Bronchopulmonary dysplasia and necrotizing enterocolitis have become modern problems of effective care of premature neonates. These two pathologies significantly delay the discharge of a premature baby from the hospital, lead to significant economic costs and worsen the quality of life of these patients. The aim of the study was to identify controlled predictors of bronchopulmonary dysplasia, however, in the analysis of the initial status of patients obtained useful results for the parallel treatment of necrotizing enterocolitis. The study recruited 133 neonates with a gestational age of 28–32 weeks with a diagnosis of respiratory distress syndrome on the basis of two NICU in Dnipro in the period from 2016 to 2020. According to the results of the study in the structure of treatment of premature neonates there were significant risks of bronchopulmonary dysplasia: the duration of respiratory support by mechanical ventilation, non-invasive ventilation, additional oxygenation, nebulizer therapy, and for necrotizing enterocolitis – lower fluid intake, hemoglobin level in 1, 3, 7 days of life, moderate and severe asphyxia. Some of the approaches in therapy are cross-cutting, such as the prevention of anemia in respiratory distress syndrome, fluid intake differences and intensive care methods reducing the duration of respiratory support for the prevention of late neonatal sepsis, we can create an algorithm that takes into account all the risks and enhance outcome for these patients. The perspectives for future work – research of neurological status of former premature neonates and finding out predictors of cerebral palsy.

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Treatment and prophylaxis of moderate and severe bronchopulmonary dysplasia in premature neonates

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.3.241961 ◽

2021 ◽

Vol 26 (3) ◽

pp. 84-93

Author(s):

A.V. Bolonska ◽

O.Yu. Sorokina

Keyword(s):

Bronchopulmonary Dysplasia ◽

Behavioral Problems ◽

Developmental Disorders ◽

Cohort Analysis ◽

Supplemental Oxygen ◽

Preterm Neonates ◽

Study Objective ◽

Premature Neonates ◽

Treatment Regimens ◽

Increased Risk

Bronchopulmonary dysplasia in premature neonates leads to physical and mental developmental disorders and behavioral problems and associated with frequent rehospitalizations and long hospital stay. Study objective: to study the predictors of bronchopulmonary dysplasia development in premature neonates in structure of intensive care. Study design: A retrospective cohort analysis was performed in 127 children recruited from two NICU of Dnipro between January 2016 to March 2020. Inclusion criteria: preterm neonates 28-32 gestation weeks with respiratory distress syndrome (RDS). Results demonstrated that every day of mechanical ventilation, supplemental oxygen with FiO2 more than 30% and cardiac drugs usage increased risk of bronchopulmonary dysplasia development by 15-20%. In conclusion, finding out predictors of bronchopulmonary dysplasia helps to improve and prudently use usual treatment regimens in premature neonates and decrease the frequency of moderate and severe bronchopulmonary dysplasia.

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