Infant Pulmonary Function Testing and Phenotypes in Severe Bronchopulmonary Dysplasia
| Autor: | Swetha Sitaram, Kathryn A. Hasenstab, Edward G. Shepherd, Daniel T. Malleske, Sudarshan R. Jadcherla, Brian J. Clouse, Leif D. Nelin |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Birth weight Population Pulmonary function testing Cohort Studies 03 medical and health sciences 0302 clinical medicine Interquartile range 030225 pediatrics Forced Expiratory Volume Intensive Care Units Neonatal Medicine Humans Prospective cohort study education Bronchopulmonary Dysplasia education.field_of_study business.industry Total Lung Capacity Infant Newborn medicine.disease Bronchodilator Agents Logistic Models Phenotype 030228 respiratory system Bronchopulmonary dysplasia Infant Extremely Low Birth Weight Infant Extremely Premature Pediatrics Perinatology and Child Health Infant Small for Gestational Age Small for gestational age Female business Cohort study |
| Zdroj: | Pediatrics. 141(5) |
| ISSN: | 1098-4275 |
| Popis: | BACKGROUND: The definition of severe bronchopulmonary dysplasia (sBPD) is based on respiratory support needs. The management of a patient with sBPD remains empirical and is highly variable among providers. Our objective in this study was to test the hypothesis that infant pulmonary function testing (iPFT) would reveal distinct phenotypes in patients with established sBPD during the initial NICU stay. METHODS: A prospective cohort study with data prospectively collected on infants with sBPD from May 1, 2003, to June 30, 2016. iPFT data were used to classify the patients as obstructive, restrictive, or mixed. RESULTS: The median gestational age at birth was 25 weeks (interquartile range [IQR], 24–27 weeks) and the median birth weight was 707 g (IQR, 581–925 g). At the time of iPFT, the median postmenstrual age was 52 weeks (IQR, 45–63 weeks), and the median weight was 4.4 kg (IQR, 3.7–6.0 kg). There were 56 (51%) patients with obstructive, 44 (40%) with mixed, and 10 (9%) with restrictive phenotypes. Moderate or severe obstruction was seen in 86% of the obstructive group and 78% of the mixed group. Of the restrictive patients, 70% had moderate and 30% had mild restriction. Bronchodilator response was seen in 74% of obstructive, 63% of mixed, and 25% of restrictive patients. CONCLUSIONS: Our findings reveal that sBPD as it is currently defined includes distinct phenotypes. Future researchers of diagnostic approaches to this population should consider the development of bedside tests to define phenotypes, and researchers in future therapeutic trials should consider the use of pulmonary function phenotyping in patient recruitment. |
| Databáze: | OpenAIRE |
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