| Encouraging pulmonary outcome for surviving, neurologically intact extremely premature infants in the post surfactant era. | |
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MedLine Citation:
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PMID: 22423043 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract OBJECTIVES:To determine long term pulmonary outcome of extreme prematurity at a single tertiary center, 1997-2001 in the post surfactant era. METHODS:We assessed symptoms, exhaled NO, spirometry, methacholine challenge (PC20), lung volumes, diffusion and cardiopulmonary exercise tolerance. RESULTS:Of 279 infants born, 192 survived to discharge and 79 of these developed BPD (65 mild, 12 moderate, 2 severe). We studied a subgroup of 53 neurologically intact preterm subjects at aged 10±1.5y: 28 with BPD-21 mild, 7 moderate and none severe- (born: 26.2 ±1.4 wks, birth weight 821 ±164 gm) and 25 without BPD (born: 27.2 ±1 wks, birth weight 1050 ± 181 gm), compared to 23 term controls. Of BPD subjects, 21 were mild, 7 moderate and none severe.77.4% received antenatal steroids and 83% post-natal surfactant. 60% preterm subjects wheezed at < 2y compared to 13% controls (p<0.001) but only 13% wheezed in the past year, compared to 0% controls (ns). For preterm subjects and controls respectively (mean± s.d., %predicted): FEV1 was 85±10% and 94±10% (p<0.001), with limited reversibility; RV/TLC was 29.3±5.5 and 25±8% (p<0.05); Diffusing capacity/alveolar volume was 89.6±9.2% and 97±10% (p<0.005); PC20 mg/ml was 6.5±5.8 and 11.7±5.5 (p<0.001). PC20 was <4mg/ml in 49% preterm subjects despite normal exhaled NO. Most measurements were similar for BPD and non-BPD premature subjects. Peak oxygen consumption and breathing reserve were normal, but maximal load (watts, mean ± s.d, %predicted) was 69±15% for BPD compared with 88±23% for non BPD and 86±20% for controls (p< 0.01). CONCLUSIONS:Pulmonary outcome was encouraging at mid-childhood for neurologically intact survivors in the post surfactant era. Despite mechanical ventilation and oxygen therapy, most had no or mild BPD. Changes found probably reflect hypoplastic lungs of prematurity. |
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Authors:
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Eytan Kaplan; Ephraim Bar Yishay; Dario Prais; Gil Klinger; Meir Mei Zahav; Huda Mussaffi; Guy Steuer; Shai Hananya; Yelena Matyashuk; Nassrin Gabarra; Lea Sirota; Hannah Blau |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-15 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-3-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Pulmonary Institute and. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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