Randomized Trial of 42-Day Compared with 9-Day Courses of Dexamethasone for the Treatment of Evolving Bronchopulmonary Dysplasia in Extremely Preterm Infants

2019 ◽  
Vol 211 ◽  
pp. 20-26.e1 ◽  
Author(s):  
Bonnie L. Marr ◽  
Barbara B. Mettelman ◽  
Michelle M. Bode ◽  
Steven J. Gross
Keyword(s):  
Randomized Trial ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Bubbly and cystic appearance on chest radiograph of extremely preterm infants with bronchopulmonary dysplasia is associated with wheezing disorder

2019 ◽  
Vol 109 (4) ◽  
pp. 711-719
Author(s):  
Hirokazu Arai ◽  
Masato Ito ◽  
Tomoo Ito ◽  
Syozo Ota ◽  
Tsutomu Takahashi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Chest Radiograph ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Duration of significant patent ductus arteriosus and bronchopulmonary dysplasia in extremely preterm infants

2019 ◽  
Vol 39 (12) ◽  
pp. 1648-1655 ◽  
Author(s):  
Hussnain Mirza ◽  
Jorge Garcia ◽  
Genevieve McKinley ◽  
Laura Hubbard ◽  
Wendla Sensing ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Ductus Arteriosus ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Patent Ductus

scholarly journals Tracheal Aspirate miRNA Signatures in Preterm Infants with Severe Bronchopulmonary Dysplasia

2021 ◽  
Author(s):  
Roopa Siddaiah ◽  
Christiana Oji-Mmuo ◽  
Deborah Montes ◽  
Nathalie Fuentes ◽  
Ann Donnelly ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Respiratory Infections ◽  
Fetal Lung ◽  
Tracheal Aspirate ◽  
Expression Levels ◽  
Fetal Lung Development ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Novel Biomarkers

Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that develops in neonates as a consequence of preterm birth and arrested fetal lung development. The incidence of BPD remains on the rise, as a result of increasing survival of extremely preterm infants. Severe BPD contributes to significant health care costs and is associated with prolonged hospitalizations, respiratory infections, and neurodevelopmental deficits. In this study, we aimed to detect novel biomarkers of severe BPD. We collected tracheal aspirates (TA) from preterm babies with mild/moderate (n = 8) and severe (n = 17) BPD, and we profiled the expression of 1048 miRNAs using a PCR array. Associations with biological pathways were determined with the Ingenuity Pathway Analysis (IPA) software. We found 31 miRNAs differentially expressed between the two disease groups (2-fold change, FDR < 0.05). Of these, 4 miRNAs displayed significantly higher expression levels, and 27 miRNAs had significantly lower expression levels in the severe BPD vs. the mild/moderate BPD group. IPA identified cell signaling and inflammation pathways associated with miRNA signatures. We conclude that TAs of extreme premature infants contain miRNA signatures associated with severe BPD. These signatures may serve as biomarkers of disease severity in infants with BPD.

scholarly journals Effects of Postnatal Hydrocortisone Treatment on Cytokine Profile in Preterm Infants at Risk of Bronchopulmonary Dysplasia

2021 ◽  
Author(s):  
Kentaro Tamura ◽  
Mitsuhide Nagaoka ◽  
Satomi Inomata ◽  
Yukako Kawasaki ◽  
Masami Makimoto ◽  
...  
Keyword(s):  
At Risk ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Early Phase ◽  
Late Phase ◽  
High Serum ◽  
Duration Of Treatment ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Hydrocortisone Treatment

Abstract Systemic hydrocortisone administration has been widely used in preterm infants who are at a risk of bronchopulmonary dysplasia (BPD). However, the effects of hydrocortisone on cytokine profiles have not been examined. We aimed to investigate the effects of postnatal hydrocortisone treatment on serum cytokine levels in extremely preterm infants at risk for BPD. In 29 extremely preterm infants (born at less than 28 weeks of gestational age), we obtained serum from blood samples collected during an early phase (5–20 days) and a late phase (28‒60 days) after birth. We measured the levels of proinflammatory cytokines (tumor necrosis factors α and β, interleukin [IL]-1β, and IL-6), T-helper (Th) 1 cytokines (interferon-γ, IL-2, and IL-12p70), Th2 cytokines (IL-4, IL-5, and IL-10), Th17 cytokine IL-17A, and chemokine IL-8. We found that serum IL-6 and IL-8 levels were significantly higher during the early phase than during the late phase (both P = 0.03). Other cytokines concentrations did not change between the phases. Thirteen infants (45%) received systemic hydrocortisone treatment at a median age of 15 days (IQR 10.0–21.5) after birth due to respiratory deterioration, after which the serum IL-6 levels significantly decreased (P = 0.04). Median duration of treatment was 16.0 (IQR 8.0–34.5) days. Conclusion: Extremely preterm infants show high serum IL-6 and IL-8 levels in the early phase of life. Moreover, postnatal systemic hydrocortisone treatment might suppress IL-6 overproduction.

scholarly journals Bronchopulmonary Dysplasia: Can We Agree on a Definition?

2018 ◽  
Vol 35 (06) ◽  
pp. 537-540 ◽  
Author(s):  
Deepak Jain ◽  
Eduardo Bancalari
Keyword(s):  
Respiratory Failure ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Nasal Cannula ◽  
Clinical Practices ◽  
Unique Challenge ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Respiratory Outcomes

AbstractThe advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy.The limitations of current definitions of BPD include inconsistent correlation with long-term respiratory outcomes, inability to classify infants dying from severe respiratory failure prior to 36 weeks' postmenstrual age, and potential inappropriate categorization of infants on nasal cannula oxygen or with extrapulmonary causes of respiratory failure. In the long term, the aim for a new definition of BPD is to develop a classification based on the pathophysiology and objective lung function evaluation providing a more accurate assessment for individual patients. Until then, a consensus definition that encompasses current clinical practices, provides reasonable prediction of later respiratory outcomes, and is relatively simple to use should be achieved.

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