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.

Trends in respiratory management of transferred very preterm infants in the last two decades

2021 ◽  
Author(s):  
Francesco Cavallin ◽  
Nicoletta Doglioni ◽  
Laura Brombin ◽  
Elisabetta Lolli ◽  
Cristina Loddo ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Respiratory Management

Characterization of lung ultrasound imaging in preterm infants with bronchopulmonary dysplasia

2021 ◽  
pp. 1-13
Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Imaging Method ◽  
Chronic Lung Diseases ◽  
Pleural Line ◽  
Ultrasound Features

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.

Neighborhood Disadvantage and Early Respiratory Outcomes in Very Preterm Infants with Bronchopulmonary Dysplasia.

2021 ◽  
Author(s):  
Juliette Deschamps ◽  
Mohamed Boucekine ◽  
Laurence Fayol ◽  
Jean Christophe Dubus ◽  
Steve Nauleau ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Neighborhood Disadvantage ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Respiratory Outcomes

scholarly journals PO-0749 Cpap Failure In Very Preterm Infants In European Regions With Different Respiratory Management Strategies: Results From The Epice Cohort

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A500.2-A500
Author(s):  
J Mazela ◽  
M Bonet ◽  
A Piedvache ◽  
O Pryds ◽  
P Truffert ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Management Strategies ◽  
European Regions ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Respiratory Management ◽  
Cpap Failure

Severity of Bronchopulmonary Dysplasia Among Very Preterm Infants in the United States

PEDIATRICS ◽  
2021 ◽  
pp. e2020030007
Author(s):  
Erik A. Jensen ◽  
Erika M. Edwards ◽  
Lucy T. Greenberg ◽  
Roger F. Soll ◽  
Danielle E.Y. Ehret ◽  
...  
Keyword(s):  
United States ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
The United States ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Response to bronchodilators in very preterm infants with evolving bronchopulmonary dysplasia

2015 ◽  
pp. 113 ◽  
Author(s):  
Daniel K Morrow ◽  
Diane Schilling ◽  
Cynthia McEvoy
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Pulse Oximetry Values in Very Preterm infants Asymtomatic at 34-36 weeks post menstrual age.

2020 ◽  
Author(s):  
Ignacio Oyarzún ◽  
Marcela Diaz ◽  
Paulina Toso ◽  
Alejandra Zamorano ◽  
Soledad Montes ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Oxygen Therapy ◽  
Healthy Children ◽  
Multicentric Study ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Postmenstrual Age

Background: Oxygen supplementation is an important component for preterm infants neonatal care. Pulse oximetry (SpO2) is essential to guide oxygen therapy. Evidence on SpO2 values in premature infants previous to discharge is limited. Objectives: To establish SpO2 values in asymptomatic premature infants at 34, 35, and 36 weeks postmenstrual age (PMA). Methods: Longitudinal, multicentric study. From May 2018 to May 2019 premature infants born ≤32 weeks gestational age, from three level III NICUs in Santiago, Chile (altitude 579mt), were enrolled. Healthy children without current apnea of prematurity were included. Continuous SpO2 was obtained with Masimo-Radical 7/8 (USA), averaging time 2-4 seconds. Results: 101 SpO2 recordings (n = 44, 33 and 24 at 34, 35 and 36 weeks PMA respectively) from 62 infants. Twenty eight (45%) male, median (range) gestational age at birth 30 (26-32) weeks, median (range) birth weight 1480 (785-2700) g. Oximetry variables for total recordings: mean SpO2, median (range) 96.9 (93.3-99.3); minimum SpO2, median (range) 74 (51-89); time of SpO2 <90%, median (range) 2% (0-10.6%); time of SpO2 <80%, median (range) 0.1% (0-1.3%); desaturation event by ≥4% (DI4) ≥ 0 and ≥ 10 seconds per sample hour, median (range) 45.2 (5.2-115) and median (range) 15 (3.5-62.5) respectively; desaturation event <80% (DI80), median (range) 0.58 (0-10.8). We found no differences between SpO2 values at different weeks PMA. Conclusions: We described SpO2 values in very preterm infants, asymptomatic at 34, 35 and 36 weeks PMA. These values could be used as a reference to guide oxygen therapy previous to discharge.

scholarly journals Validation of an MRI Brain Injury and Growth Scoring System in Very Preterm Infants Scanned at 29- to 35-Week Postmenstrual Age

2017 ◽  
Vol 38 (7) ◽  
pp. 1435-1442 ◽  
Author(s):  
J.M. George ◽  
S. Fiori ◽  
J. Fripp ◽  
K. Pannek ◽  
J. Bursle ◽  
...  
Keyword(s):  
Brain Injury ◽  
Preterm Infants ◽  
Scoring System ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Mri Brain ◽  
Postmenstrual Age

scholarly journals Bronchopulmonary dysplasia in very preterm infants: Outcome up to preschool age, in a single center of Austria

2019 ◽  
Vol 61 (4) ◽  
pp. 381-387 ◽  
Author(s):  
Friedrich Reiterer ◽  
Anna Scheuchenegger ◽  
Bernhard Resch ◽  
Ute Maurer‐Fellbaum ◽  
Alexander Avian ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Preschool Age ◽  
Single Center ◽  
Very Preterm Infants ◽  
Very Preterm
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