scholarly journals 258 Fetal Haemoglobin Levels in Preterm Infants at 36 Weeks Postmenstrual Age: Effect of Bronchopulmonary Dysplasia, Sepsis and Transfusions

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A75-A75
Author(s):  
B. Perrone ◽  
P. Marchionni ◽  
A. Bartoli ◽  
C. Gidiucci ◽  
M. Pasqualini ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Age Effect ◽  
Fetal Haemoglobin ◽  
Postmenstrual Age

Lung Ultrasound in Bronchopulmonary Dysplasia: Patterns and Predictors in Very Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Victoria Aldecoa-Bilbao ◽  
Mar Velilla ◽  
Marta Teresa-Palacio ◽  
Carla Balcells Esponera ◽  
Ana Herranz Barbero ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Lung Ultrasound ◽  
Respiratory Support ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Pleural Line ◽  
Respiratory Management ◽  
Postmenstrual Age ◽  
Severity Of The Disease

<b><i>Introduction:</i></b> Lung ultrasound (LUS) is useful for respiratory management in very preterm infants (VPI), but little is known about the echographic patterns in bronchopulmonary dysplasia (BPD), the relation between the image findings, and the severity of the disease and its long-term outcomes. We aimed to describe LUS patterns in BPD and analyze the accuracy of LUS to predict the need for respiratory support at 36 weeks postmenstrual age (PMA) in VPI. <b><i>Methods:</i></b> Preterm infants ≤30.6 weeks of gestational age were recruited. LUS was performed at admission, at 7th, and 28th day of life (DOL) with a standardized protocol (6 zones: anterior, lateral, and posterior fields). Clinical data, respiratory outcomes, and image findings were recorded. <b><i>Results:</i></b> Eighty-nine patients were studied. Infants with BPD had significantly higher LUS score at admission, at 7th, and 28th DOL. Patients with BPD exhibited more consolidations and pleural line abnormalities at 7th and 28th DOL than those without BPD (<i>p</i> &#x3c; 0.001), regardless of the definition used for BPD. LUS at 7th DOL predicted <i>NICHD 2001-BPD</i> with <i>R</i><sup>2</sup> = 0.522; AUC = 0.87 (0.79–0.94), <i>p</i> &#x3c; 0.001, and <i>Jensen 2019-BPD</i> with <i>R</i><sup>2</sup> = 0.315 (AUC = 0.80 [0.70–0.90], <i>p</i> &#x3c; 0.001). A model including mechanical ventilation &#x3e;5 days, oxygen therapy for 7 days and LUS score at 7th DOL accurately predicted the need for respiratory support at 36 weeks PMA (<i>R</i><sup>2</sup> = 0.655, <i>p</i> &#x3c; 0.001) with an AUC = 0.90 (0.84–0.97), <i>p</i> &#x3c; 0.001. <b><i>Conclusion:</i></b> LUS score, pleural line abnormalities, and consolidations can be useful to diagnose BPD in VPI and to predict its severity after the first week of life.

scholarly journals Fetal haemoglobin and bronchopulmonary dysplasia in neonates: an observational study

2020 ◽  
Vol 106 (1) ◽  
pp. 88-92
Author(s):  
William Hellström ◽  
Tobias Martinsson ◽  
Ann Hellstrom ◽  
Eva Morsing ◽  
David Ley
Keyword(s):  
Observational Study ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Randomised Trial ◽  
Blood Components ◽  
Very Preterm Infants ◽  
Arterial Blood Gas ◽  
Fetal Haemoglobin ◽  
Very Preterm ◽  
Arterial Blood

ObjectiveEarly decrease in fetal haemoglobin (HbF) is an indicator of loss of endogenous blood components that might have predictive value for development of bronchopulmonary dysplasia (BPD). The link between HbF and BPD has not been evaluated.DesignRetrospective observational study.SettingTertiary level neonatal intensive care unit, referral centre for Southern Sweden.Patients452 very preterm infants (<30 gestational weeks) born 2009–2015.InterventionsRegular clinical practice.Main outcome measuresMean HbF, haemoglobin (Hb) and partial oxygen pressure (PaO2) levels calculated from 11 861 arterial blood gas analyses postnatal week 1. Relationship between HbF (%) and BPD (requirement of supplemental oxygen at 36 weeks’ postmenstrual age) and the modifying influence of PaO2 (kPa) and total Hb (g/L) was evaluated.ResultsThe mean gestational age (GA) at birth was 26.4 weeks, and 213 (56%) infants developed BPD. A 10% increase in HbF was associated with a decreased prevalence of BPD, OR 0.64 (95% CI 0.49 to 0.83; p<0.001). This association remained when adjusting for mean PaO2 and Hb. Infants with an HbF in the lowest quartile had an OR of 27.1 (95% CI 11.6 to 63.4; p<0.001) for development of BPD as compared with those in the highest quartile. The area under the curve for HbF levels and development of BPD in the full statistical model was 0.871.ConclusionsEarly rapid postnatal decline in HbF levels was associated with development of BPD in very preterm infants. The association between HbF and BPD was not mediated by increased oxygen exposure. The potential benefit of minimising loss of endogenous blood components on BPD outcome will be investigated in a multicentre randomised trial.

scholarly journals Left Ventricle Phenotyping Utilizing Tissue Doppler Imaging in Premature Infants with Varying Severity of Bronchopulmonary Dysplasia

2021 ◽  
Vol 10 (10) ◽  
pp. 2211
Author(s):  
Eunice Torres ◽  
Philip T. Levy ◽  
Afif El-Khuffash ◽  
Hongjie Gu ◽  
Aaron Hamvas ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Tissue Doppler Imaging ◽  
Myocardial Dysfunction ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Pulmonary Vascular Disease ◽  
Lv Function ◽  
Postmenstrual Age

Bronchopulmonary dysplasia (BPD) is characterized by alveolar-capillary simplification and is associated with pulmonary hypertension (PH) in preterm infants. The contribution of left ventricle (LV) disease towards this severe BPD-PH phenotype is not well established. We aimed to describe the longitudinal trajectory of the LV function as measured by tissue Doppler imaging (TDI) and its association with BPD-PH. We retrospectively assessed prospectively acquired clinical and echocardiographic data from 77 preterm infants born between 2011 and 2013. We characterized the LV function by measuring systolic and diastolic myocardial velocities (s’, e’, a’), isovolumetric relaxation time (IVRT), and myocardial performance index with TDI at three time periods from 32 and 36 weeks, postmenstrual age through one year of age. We also measured post systolic motion (PSM), a marker of myocardial dysfunction that results from asynchronous movement of the ventricular walls, and not previously described in preterm infants. Patients were stratified into groups according to BPD severity and the presence of PH and compared over time. Conventional TDI measures of the LV function were similar between groups, but the septal PSM was significantly prolonged over the first year of age in patients with BPD-PH. PSM provides a novel objective way to assess the hemodynamic impact of lung and pulmonary vascular disease severity on LV function in preterm infants with BPD and PH.

scholarly journals Early angiogenic proteins associated with high risk for bronchopulmonary dysplasia and pulmonary hypertension in preterm infants

2020 ◽  
Vol 318 (4) ◽  
pp. L644-L654 ◽  
Author(s):  
Sanne Arjaans ◽  
Brandie D. Wagner ◽  
Peter M. Mourani ◽  
Erica W. Mandell ◽  
Brenda B. Poindexter ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Subsequent Development ◽  
Pulmonary Vascular Disease ◽  
Morphogenetic Protein ◽  
Angiogenic Proteins ◽  
Postmenstrual Age ◽  
Hepatocyte Growth ◽  
Increased Susceptibility

Early pulmonary vascular disease in preterm infants is associated with the subsequent development of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH); however, mechanisms that contribute to or identify infants with increased susceptibility for BPD and/or PH are incompletely understood. Therefore, we tested if changes in circulating angiogenic peptides during the first week of life are associated with the later development of BPD and/or PH. We further sought to determine alternate peptides and related signaling pathways with the risk for BPD or PH. We prospectively enrolled infants with gestational age <34 wk and collected blood samples during their first week of life. BPD and PH were assessed at 36 wk postmenstrual age. Samples were assayed for each of the 1,121 peptides included in the SOMAscan scan technology, with subsequent pathway analysis. Of 102 infants in the study, 82 had BPD, and 13 had PH. Multiple angiogenic proteins (PF-4, VEGF121, ANG-1, bone morphogenetic protein 10 [BMP10], hepatocyte growth factor (HGF), ANG-2) were associated with the subsequent diagnosis of BPD; and FGF-19, PF-4, connective tissue activating peptide (CTAP)-III, and PDGF-AA levels were associated with BPD severity. Early increases in BMP10 was strongly associated with the late risk for BPD and PH. We found that early alterations of circulating angiogenic peptides and others were associated with the subsequent development of BPD. We further identified peptides that were associated with BPD severity and BPD-associated PH, including BMP10. We speculate that proteomic biomarkers during the first week of life may identify infants at risk for BPD and/or PH to enhance care and research.

scholarly journals The Association between early Gram-negative bacteria in tracheal aspirate cultures and severe bronchopulmonary dysplasia among extremely preterm infants requiring prolonged ventilation

2021 ◽  
Author(s):  
Yousuke Imanishi ◽  
Katsuya Hirata ◽  
Masatoshi Nozaki ◽  
Narutaka Mochizuki ◽  
Shinya Hirano ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Tracheal Aspirate ◽  
Multivariable Logistic Regression Analysis ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Postmenstrual Age

Objective: To evaluate the association between bronchopulmonary dysplasia (BPD) development at 36 weeks postmenstrual age (PMA) and Gram-negative bacteria in tracheal aspirate cultures among extremely preterm infants. Study Design: Retrospective cohort study. Patients were 155 infants aged less than or equal to 26 gestational weeks who were admitted to the neonatal intensive care unit of Osaka Women’s and Children’s Hospital from 2009 to 2018. Primary outcome was respiratory outcomes expressed as BPD development. Multivariable logistic regression analysis was used to identify neonatal and bacterial factors associated with BPD. Results: After adjusting for gestational age, birth weight, sex, chorioamnionitis, Gram-positive cocci (GPC) and Gram-negative rods (GNRs) in tracheal aspirate cultures within 28 days after birth, GNRs were significantly associated with BPD development (odds ratio [OR]: 3.88, 95% confidence interval [CI]: 1.68–8.94). In contrast, GPC were not associated with BPD development (OR: 0.47, 95% CI: 0.05–1.61). Conclusion: Gram-negative bacteria in tracheal cultures within 28 days of birth are associated with BPD development in infants aged less than or equal to 26 gestational weeks.

scholarly journals Incidence, risk factors, and outcomes of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia

2019 ◽  
Vol 25 (4) ◽  
pp. 222-227 ◽  
Author(s):  
Katelyn MacKenzie ◽  
Kathy Cunningham ◽  
Sumesh Thomas ◽  
Tapas Mondal ◽  
Salhab el Helou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Significant Risk ◽  
Control Groups ◽  
Short Term ◽  
Postmenstrual Age ◽  
Incidence Risk ◽  
Echocardiographic Assessment

Abstract Objectives To determine the incidence and risk factors for pulmonary hypertension (PH) in preterm infants with moderate to severe bronchopulmonary dysplasia (BPD) and to compare short-term outcomes. Methods Preterm infants &lt;32 weeks gestation born August 2013 through July 2015 with moderate to severe BPD at 36 weeks postmenstrual age were categorized into BPD-PH (exposure) and BPD-noPH (control) groups. Results Of 92 infants with BPD, 87 had echocardiographic assessment, of whom 24 (28%) had PH. On multiple logistic regression after adjustment for gestational age and sex, no significant risk factors for PH were identified based on data from this cohort. There were no differences in resource utilization or clinical outcomes including survival to discharge. Conclusion Approximately one out of four patients with moderate to severe BPD were identified as having PH. No significant risk factors for PH were identified. No differences in outcomes were identified for those with and without PH.

Pulmonary Gas Exchange Improves over the First Year in Preterm Infants with and without Bronchopulmonary Dysplasia

Neonatology ◽  
2021 ◽  
Vol 118 (1) ◽  
pp. 98-105
Author(s):  
Y. Jane Choi ◽  
Benjamin Stoecklin ◽  
Naomi R. Hemy ◽  
Graham L. Hall ◽  
Dorota A. Doherty ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Pulmonary Gas Exchange ◽  
First Year ◽  
Term Infants ◽  
Extremely Preterm ◽  
Postmenstrual Age ◽  
First Year Of Life ◽  
The Impact

Background: Right shift of the peripheral oxyhaemoglobin saturation (SpO2) versus inspired oxygen pressure (PIO2) curve is a sensitive marker of pulmonary gas exchange. Objectives: The aim of this study was to assess the impact of prematurity and bronchopulmonary dysplasia (BPD) on gas exchange and right-to-left shunt in the neonatal period, and its evolution over the first year of life. Method: We assessed shift and shunt in extremely preterm (EP) and very preterm (VP) infants at 36 and 44 weeks’ postmenstrual age (PMA), and at 1-year corrected postnatal age (cPNA). PIO2 was decreased stepwise to achieve SpO2 between 85 and 98%. Shift and shunt were calculated from paired SpO2/PIO2 measurements using customized software. Results were examined cross-sectionally at each time point, and longitudinally using generalized linear regression. Term infants were assessed at 44 wk PMA as a comparative reference. Results: Longitudinal modelling showed continuous decline in shift in EP and VP infants during the first year of life. There was no difference in shift compared to term infants at 44 wk PMA (p = 0.094). EP infants with BPD had higher shift than infants without BPD at 36 wk PMA (p < 0.001) and 44 wk PMA (p = 0.005) but not at 1-year cPNA. Conclusions: In the absence of lung disease, prematurity per se did not result in reduced gas exchange at 1-year cPNA. We report ongoing, significant improvements in pulmonary gas exchange in all preterm infants during the first year of life, despite evidence of early deficits in gas exchange in EP infants with BPD.

scholarly journals Association of Newer Definitions of Bronchopulmonary Dysplasia with Pulmonary Hypertension and Long-Term Outcomes

2021 ◽  
Author(s):  
Jae Kyoon Hwang ◽  
Seung Han Shin ◽  
Ee-Kyung Kim ◽  
Seh Hyun Kim ◽  
Han-Suk Kim
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Multiple Logistic Regression Analysis ◽  
Respiratory Illness ◽  
Long Term Outcomes ◽  
Postmenstrual Age ◽  
Study Population ◽  
Grade 3 ◽  
Definition Of

Abstract The diagnostic criteria of bronchopulmonary dysplasia (BPD) have been reassessed based on current practices and highest accuracy in predicting long-term outcomes. We investigated the association between BPD severity based on different definitions in terms of long-term outcomes and pulmonary arterial hypertension (PAH). This retrospective study enrolled preterm infants born at <32 weeks of gestation. The definition of BPD recommended by the National Institutes of Health in 2001, National Institute of Child Health and Human Development (NICHD) in 2018, and Jensen et al. in 2019 were used. The association between re-hospitalization due to respiratory illness, neurodevelopmental impairment (NDI) at a corrected age of 18–24 months, and PAH at a postmenstrual age (PMA) of 36 weeks with the severity of BPD based on these three definitions were evaluated. Among 354 infants, gestational age (26.9 weeks) and birth weight (730 g) were lowest in severe BPD based on NIH 2001 definition. In total, 14.1% of study population experienced NDI and 19.0% were re-hospitalized due to respiratory illness. Multiple logistic regression analysis showed that the adjusted odds ratio (OR) for re-hospitalization was highest in grade-3 BPD of the Jensen (2019) criteria (7.45). The adjusted OR for NDI (13.23) and PAH (40.37) were also highest in grade-3 of the Jensen (2019) criteria.Conclusion: Based on recently suggested criteria, severity of BPD is associated with long-term outcomes and PAH at PMA of 36 weeks in preterm infants.

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