Document Detail

Pulmonary outcome in extremely low birth weight infants.
MedLine Citation:
PMID:  10835059     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether infants with hyaline membrane disease (HMD) superimposed on immature lung disease (ILD) have more abnormal lung function and respiratory drive during the evolution of chronic neonatal lung disease (CNLD) in extremely low birth weight infants (ELBW; <1000 g). METHODS: We measured lung mechanics (respiratory frequency, tidal volume, minute ventilation, lung resistance, lung compliance, lung impedance, and work of breathing per minute) and respiratory drive (airway opening pressure 100 milliseconds after initiation of breath [P(0.1)] and maximal inspiratory pressure generated during airway occlusion) on 3 occasions before term in 24 ELBW infants. RESULTS: Ten infants with ILD (mean [95% CI] gestation: 24.3 weeks [23.1,25.4]; birth weight: 675 g [553,798]) were studied at 27, 31, and 35 weeks of postconceptional age and 14 infants with HMD superimposed on ILD (gestation: 25.1 weeks [24.4,25.9]; birth weight: 687 g [601,773]) were studied at 28, 32, and 35 weeks of postconceptional age. There were no statistically significant differences between the groups for respiratory frequency, tidal volume, minute ventilation, lung resistance, lung compliance, lung impedance, work of breathing per minute, P(0.1), and maximal inspiratory pressure generated during airway occlusion. With increasing age, both groups demonstrated increased respiratory drive as measured by P(0.1) without significant changes in respiratory frequency or CO(2). Work of breathing per minute increased in the HMD group with age and was higher in extubated subjects. A similar trend with age was demonstrated in ILD infants. Regardless of whether the initial lung disease was ILD alone or HMD + ILD, ELBW infants developed a mildly reduced lung compliance/kg (.8-1.1 mL/cm.H(2)O/kg) and high lung resistance (75-125 cm.H(2)O/L/second) pattern of CNLD, which changed little after 3 weeks of age. Survival to 6 months was 23/24 (96%). Oxygen dependency was 16/24 (67%) at 35 weeks, yet only 5/23 (22%) survivors required oxygen at discharge from the neonatal unit (43 weeks). CONCLUSIONS: The visco-elastic and flow-resistive properties of the lungs in ELBW infants with CNLD remain only mildly abnormal, suggesting a more favorable prognosis for lung function in later years than previously reported.
D A Fitzgerald; G Mesiano; L Brosseau; G M Davis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  105     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-06-28     Completed Date:  2000-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1209-15     Citation Subset:  AIM; IM    
Children's Chest Research Centre, New Children's Hospital, Sydney, Australia.
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MeSH Terms
Chronic Disease
Hyaline Membrane Disease / physiopathology*
Infant, Newborn
Infant, Very Low Birth Weight*
Lung Diseases / physiopathology*
Respiratory Function Tests
Respiratory Mechanics*

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