The impact of oxygen therapy in preterm infants with bronchopulmonary dysplasia

Author(s):  
Cristina Tomacinschii ◽  
Aliona Cotoman ◽  
Svetlana Sciuca ◽  
Rodica Selevestru ◽  
Olesea Aioani
PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 913-917
Author(s):  
J. A. Smyth ◽  
I. L. Metcalfe ◽  
P. Duffty ◽  
F. Possmayer ◽  
M. H. Bryan ◽  
...  

Six preterm infants with severe hyaline membrane disease requiring ventilation were treated, at a median age of 15.5 hours, with a single intratracheal bolus of a bovine surfactant suspension. Arterial oxygenation increased dramatically, and chest radiograms showed improvement after two to four hours. However, a variable degree of deterioration occurred within 24 hours. All of the infants required oxygen therapy for several weeks, and one developed severe bronchopulmonary dysplasia.


Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2729
Author(s):  
Carlos Zozaya ◽  
Alejandro Avila-Alvarez ◽  
Fermín García-Muñoz Rodrigo ◽  
María L. Couce ◽  
Luis Arruza ◽  
...  

Postnatal steroids, often used to prevent and treat bronchopulmonary dysplasia, may influence the growth of preterm infants, although data are scarce in the literature. This is a multicenter cohort study including surviving preterm infants <32 weeks at birth (n = 17,621) from the Spanish Neonatal Network SEN1500 database, without major congenital malformations. Linear regression models were adjusted for postnatal steroids, respiratory severity course (invasive mechanical ventilation at 28 days), progression to moderate–severe bronchopulmonary dysplasia (O2 at 36 weeks), length of stay, sex, gestational age and z-scores at birth. A subgroup analysis depending on the timing of administration, ventilation status at 28 days and moderate–severe BPD diagnosis was also performed. Overall, systemic postnatal steroids were not independently associated with poorer weight gain (0.1; 95% CI: −0.05 to 0.2 g/kg/day), linear growth (0; 95% CI: −0.03 to 0.01 cm/week) or head circumference growth (−0.01; 95% CI: −0.02 to 0 cm/week). Patients who received steroids after 28 days or who were not O2 dependent at 36 weeks after having received steroids gained more weight (0.22; 95% CI: 0.04 to 0.4 and 0.2; 95% CI: 0.004 to 0.5 g/kg/day, respectively). Globally, systemic postnatal steroids had no significant adjusted effect on postnatal growth.


Author(s):  
Róża Borecka ◽  
Ryszard Lauterbach

IntroductionBronchopulmonary dysplasia (BPD) is a chronic lung disease diagnosed in premature infants, which may cause severe respiratory failure due to respiratory syncytial virus (RSV) infection. The aim of this study was to assess the incidence and severity of BPD in infants born before 28 weeks of gestational age (GA) enrolled into the Polish National Program for RSV Prophylaxis (PNPRSVP).Material and methodsA retrospective analysis of data on children born in 2013 included in a prophylaxis program during the seasons 2012–2013 and 2013–2014. The following data were evaluated: the need for oxygen therapy for at least 28 days and the need for oxygen therapy at 36 weeks of postmenstrual age (PMA).ResultsThe analysis was carried out in a group of 603 children, who constituted 87.7% of the population entitled to prophylactic administration of palivizumab. BPD was diagnosed in 80.9% of extremely preterm infants; however, in 70.7% of cases the disease was mild. The risk factors for the development of BPD were GA, birth weight and birth weight below the 10th centile for GA. During the program, the median number of doses received was 5 (range 1–5), and 82.3% of children received all of the expected doses.ConclusionsAlthough the incidence of BPD in extremely preterm infants was high, mainly its mild form was recognized. Monitoring of the incidence of the disease and identifying the risk factors can be carried out effectively based on long-term data collected during the PNPRSVP.


2020 ◽  
Vol 3 ◽  
Author(s):  
Robert Minturn ◽  
Mary Beth Koch ◽  
Emily Anderson ◽  
Kok Lim Kua ◽  
Kathryn Haider

Background/Objective:  Retinopathy of Prematurity (ROP) is a leading causes of childhood blindness.  It affects 15,000 surviving US preterm infants annually, with 1,400 infants developing severe ROP and 500 infants developing legal blindness.  The pathogenesis of ROP involves 2 phases: During phase 1, the immature retinal vascularization is obliterated due to hyperoxia. During phase 2 (>4 weeks postnatally), abnormal neovascularization occurs due to hypoxia, sometimes requiring surgical intervention.   We retrospectively evaluated the impact of late supplemental oxygen (>4 weeks postnatally) on ROP progression in infants born <28 weeks.   Methods:  Preterm infants <28 weeks with >stage 2 ROP admitted to the Riley Hospital for Children Neonatal Intensive Care Unit (NICU) from 7/2017- 12/2019 were included. Nine patients treated with supplemental oxygen therapy were compared to a control cohort managed by a standard protocol after the diagnosis of stage 2 ROP.  The primary outcome was the need for surgical intervention with either laser or bevacizumab treatment. Continuous data was analyzed using unpaired t-test, and categorical data was analyzed using fishers exact test.   Results:  There was no statistical difference in regard to clinical variables contributing to risk of severe ROP (sex, race, birthweight necrotizing enterocolitis, bronchopulmonary dysplasia or length of stay) between the two study cohorts. There was a statistically significant decrease in need for treatments (laser or bevacizumab) in patients receiving supplemental oxygen (control: 35/83 patients treated, late O2: 0/9 patients treated, p=0.012).   Conclusion and Implications:  Supplemental oxygen therapy seems to have a protective effect on the development of treatable ROP (type I).  Limiting surgical intervention (laser or bevacizumab) would directly benefit the babies by decreasing the need for sedation and any inherent risks of surgery. This initial data suggests the need for future studies with a higher sample size to validate the efficacy of late supplemental O2 in ROP.       Study Group  Control       Number (Mean)  % (SD)  Number (Mean)  % (SD)  p-value  Population (N)  9  -  83  -     Sex              Male  2  22.2%  35  42.2%  N.S.  Female  7  77.8%  48  57.8%  N.S.  Race              Caucasian  5  55.6%  44  53.0%  N.S.  Non-Caucasian  4  44.4%  39  47.0%  N.S.  Birthweight (grams)  698  145.26  721  197.09  N.S.  Gestational Age (Weeks)  24.94  1.19  25.32  1.72  N.S.  Length of Stay (Days)  129.22  27.13  148.58  67.97  N.S.  Necrotizing Enterocolitis              Yes  3  33.3%  21  25.3%  N.S.  No  6  66.7%  62  74.7%  N.S.  Sepsis              Yes  6  66.7%  41  49.4%  N.S.  No  3  33.3%  42  50.6%  N.S.  Bronchopulmonary Dysplasia              Yes  9  100.0%  80  96.4%  N.S.  No  0  0.0%  2  2.4%  N.S.  Need for Additional Treatment (Inpatient)              Yes  0  0.0%  35  42.2%  N.S.  No  9  100.0%  48  57.8%  N.S.  Need for Additional Treatment (Outpatient)              Yes  0  0.0%  35  42.2%  0.012  No  9  100.0%  48  57.8%    


Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 283
Author(s):  
Deepak Jain ◽  
Alexander Feldman ◽  
Subhasri Sangam

Premature birth has been shown to be associated with adverse respiratory health in children and adults; children diagnosed with bronchopulmonary dysplasia (BPD) in infancy are at particularly high risk. Since its first description by Northway et al. about half a century ago, the definition of BPD has gone through several iterations reflecting the changes in the patient population, advancements in knowledge of lung development and injury, and improvements in perinatal care practices. One of the key benchmarks for optimally defining BPD has been the ability to predict long-term respiratory and health outcomes. This definition is needed by multiple stakeholders for hosts of reasons including: providing parents with some expectations for the future, to guide clinicians for developing longer term follow-up practices, to assist policy makers to allocate resources, and to support researchers involved in developing preventive or therapeutic strategies and designing studies with meaningful outcome measures. Long-term respiratory outcomes in preterm infants with BPD have shown variable results reflecting not only limitations of the current definition of BPD, but also potentially the impact of other prenatal, postnatal and childhood factors on the respiratory health. In this manuscript, we present an overview of the long-term respiratory outcomes in infants with BPD and discuss the role of other modifiable or non-modifiable factors affecting respiratory health in preterm infants. We will also discuss the limitations of using BPD as a predictor of respiratory morbidities and some of the recent advances in delineating the causes and severity of respiratory insufficiency in infants diagnosed with BPD.


2021 ◽  
Vol 9 ◽  
Author(s):  
Theresa Thiess ◽  
Tina Lauer ◽  
Annika Woesler ◽  
Janine Neusius ◽  
Sandro Stehle ◽  
...  

Background: Bronchopulmonary dysplasia (BPD) has multifactorial origins and is characterized by distorted physiological lung development. The impact of nutrition on the incidence of BPD is less studied so far.Methods: A retrospective single center analysis was performed on n = 207 preterm infants &lt;1,000 g and &lt;32 weeks of gestation without severe gastrointestinal complications to assess the impact of variations in nutritional supply during the first 2 weeks of life on the pulmonary outcome. Infants were grouped into no/mild and moderate/severe BPD to separate minor and major limitations in lung function.Results: After risk adjustment for gestational age, birth weight, sex, multiples, and antenatal steroids, a reduced total caloric intake and carbohydrate supply as the dominant energy source during the first 2 weeks of life prevailed statistically significant in infants developing moderate/severe BPD (p &lt; 0.05). Enteral nutritional supply was increased at a slower rate with prolonged need for parenteral nutrition in the moderate/severe BPD group while breast milk provision and objective criteria of feeding intolerance were equally distributed in both groups.Conclusion: Early high caloric intake is correlated with a better pulmonary outcome in preterm infants &lt;1,000 g. Our results are in line with the known strong impact of nutrient supply on somatic growth and psychomotor development. Our data encourage paying special attention to further decipher the ideal nutritional requirements for unrestricted lung development and promoting progressive enteral nutrition in the absence of objective criteria of feeding intolerance.


2018 ◽  
Vol 203 ◽  
pp. 218-224.e3 ◽  
Author(s):  
Joanne M. Lagatta ◽  
Erik B. Hysinger ◽  
Isabella Zaniletti ◽  
Erica M. Wymore ◽  
Shilpa Vyas-Read ◽  
...  

2019 ◽  
Vol 205 ◽  
pp. 70-76.e2 ◽  
Author(s):  
Wissam Shalish ◽  
Lara Kanbar ◽  
Lajos Kovacs ◽  
Sanjay Chawla ◽  
Martin Keszler ◽  
...  

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