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Bronchopulmonary dysplasia AND preterm infant

Junyi Wang, Wenbin Dong
With the progress of modern medicine, oxygen therapy has become a crucial measure for the treatment of premature infants. As an environmental stimulus, in the normal development of lungs, oxygen plays a very important regulatory role. However, the problem is that long-term exposure to hyperoxia can interfere with the development of lungs, leading to irreversible developmental abnormalities. Now, the incidence of bronchopulmonary dysplasia (BPD) is increasing year by year. The existing related research shows that although BPD is a multi-factor triggered disease, its main risk factors are the premature exposure to hyperoxia and the role of reactive oxygen species (ROS)...
August 8, 2018: Gene
Clement L Ren, Rui Feng, Stephanie D Davis, Eric Eichenwald, Alan Jobe, Paul E Moore, Howard B Panitch, Jack K Sharp, Jeff Kisling, Charles Clem, James S Kemp
RATIONALE: The relationship between respiratory function at hospital discharge and the severity of later respiratory disease in extremely low gestational age neonates is not well defined. OBJECTIVES: To test the hypothesis that tidal breathing measurements near the time of hospital discharge differ between extremely premature infants with BPD or respiratory disease in the first year of life compared to those without these conditions. METHODS: Study subjects were part of the Prematurity and Respiratory Outcomes Program (PROP) study, a longitudinal cohort study of infants born <29 gestational weeks followed from birth to 1 year of age...
August 8, 2018: Annals of the American Thoracic Society
Amrit Kumar Shrestha, Renuka T Menon, Binoy Shivanna
Hyperoxia-induced oxidative stress contributes to the pathogenesis of bronchopulmonary dysplasia (BPD), the most common respiratory morbidity of preterm infants. Importantly, the disease lack specific therapies and is associated with long-term cardio-pulmonary and neurodevelopmental morbidities, signifying the need to discover novel therapies and decrease the disease burden. We and others have demonstrated that leflunomide, a food and drug administration approved drug to treat humans with rheumatoid arthritis, increases the expression of the anti-oxidant enzymes, NAD(P)H quinone dehydrogenase 1 (NQO1), catalase, and superoxide dismutase (SOD)...
August 1, 2018: Biochemical and Biophysical Research Communications
Tim Hundscheid, Wes Onland, Bart van Overmeire, Peter Dijk, Anton H L C van Kaam, Koen P Dijkman, Elisabeth M W Kooi, Eduardo Villamor, André A Kroon, Remco Visser, Daniel C Vijlbrief, Susanne M de Tollenaer, Filip Cools, David van Laere, Anne-Britt Johansson, Catheline Hocq, Alexandra Zecic, Eddy Adang, Rogier Donders, Willem de Vries, Arno F J van Heijst, Willem P de Boode
BACKGROUND: Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality...
August 4, 2018: BMC Pediatrics
Haoyang Zhang, Jing Liu, Tianhao Liu, Yu Wang, Weidan Dai
INTRODUCTION: High incidence of respiratory distress syndrome (RDS) was revealed in preterm infants, which acted as one of the main factors that led to infant death. OBJECTIVES: This network meta-analysis (NMA) was performed to rank the efficacy of different therapies in preventing for premature infants. METHODS: PubMed, Embase, Cochrane Library, CINAHL and CNKI were searched. Statistical analysis was performed using STATA statistical software (Version 12...
August 3, 2018: Clinical Respiratory Journal
Willem P de Boode, Yogen Singh, Zoltan Molnar, Ulf Schubert, Marilena Savoia, Arvind Sehgal, Philip Levy, Patrick McNamara, Afif El-Khuffash
Pulmonary hypertension contributes to morbidity and mortality in both the term newborn infant, referred to as persistent pulmonary hypertension of the newborn (PPHN), and the premature infant, in the setting of abnormal pulmonary vasculature development and arrested growth. In the term infant, PPHN is characterized by the failure of the physiological postnatal decrease in pulmonary vascular resistance that results in impaired oxygenation, right ventricular failure, and pulmonary-to-systemic shunting. The pulmonary vasculature is either maladapted, maldeveloped, or underdeveloped...
July 2018: Pediatric Research
Anoop Pahuja, Katie Hunt, Vadivelam Murthy, Prashanth Bhat, Ravindra Bhat, Anthony D Milner, Anne Greenough
Intraventricular haemorrhage (IVH) and bronchopulmonary dysplasia (BPD) are major complications of premature birth. We tested the hypotheses that prematurely born infants who developed an IVH or BPD would have high expiratory tidal volumes (VTE ) (VTE  > 6 ml/kg) and/or low-end tidal carbon dioxide (ETCO2 ) levels (ETCO2 levels < 4.5 kPa) as recorded by respiratory function monitoring or hyperoxia (oxygen saturation (SaO2 ) > 95%) during resuscitation in the delivery suite. Seventy infants, median gestational age 27 weeks (range 23-33), were assessed; 31 developed an IVH and 43 developed BPD...
July 31, 2018: European Journal of Pediatrics
Gabrielle G G Bueno, Marina Carvalho de Moraes Barros, Ruth Guinsburg
OBJECTIVE: To evaluate the association between intra-ventricular hemorrhage and habituation responses to stimuli in preterm infants at 36-38 weeks post-conceptual age. METHODS: Cross-sectional study of infants with gestational age <32 weeks. Intra-ventricular hemorrhage was identified by cranial ultrasonography and classified according to Papile et al. (flashlight), sound (rattle, bell), and tactile stimuli were presented, and the responses were scored according to Lester and Tronik...
July 27, 2018: Jornal de Pediatria
Mounira Habli, Corey C Clifford, Tammy M Brady, Zahidee Rodriguez, Michaela Eschenbacher, Malcolm Wu, Emily DeFranco, James Gresh, Beena D Kamath-Rayne
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used as tocolytics, which are medications that suppress uterine contractions for preterm birth prevention. Their effect on cerebral/systemic vascular beds poses the question of whether antenatal NSAID exposure is associated with neonatal hypertension. We performed a retrospective case-control study in a tertiary neonatal intensive care unit, including 40 hypertension cases (hospitalized neonates ≥ 35 weeks with systolic BP > 100 mm Hg on three consecutive days) compared to 134 controls matched by gestational age at delivery, plurality, and delivery date...
July 27, 2018: Journal of Clinical Hypertension
Pedro C Marques, Gustavo Rocha, Filipa Flor-De-Lima, Hercília Guimarães
BACKGROUND: Extrauterine growth restriction (EUGR) remains a serious problem among very low birth weight (VLBW) infants and is a marker of severe nutritional deficit during the first weeks of life. It can lead to a higher risk of growth impairment during childhood and long-term medical problems. The aim of this study is to determine the prevalence and risk factors of EUGR in preterm infants below 1500 grams. METHODS: Descriptive retrospective study of all preterm infants with birth weight below 1500 grams who were born at and discharged from our center, from January 1, 2012 to December 31, 2016...
July 23, 2018: Minerva Pediatrica
Yang Liu, Wen-Bin Dong
With the increase in the rescue success rate of critically ill preterm infants and extremely preterm infants, the incidence rate of bronchopulmonary dysplasia (BPD) is increasing year by year. BPD has a high mortality rate and high possibility of sequelae, which greatly affects the quality of life of preterm infants and brings a heavy burden to their families, and so the treatment of BPD is of vital importance. At present, no consensus has been reached on the treatment measures for BPD. However, recent studies have shown that early application of caffeine can prevent BPD...
July 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Oreoluwa Olaloko, Raihan Mohammed, Utkarsh Ojha
Approximately 15 million babies worldwide are born premature, and complications of prematurity are one of the leading causes of death in neonates. Neonatal respiratory distress syndrome (NRDS) and bronchopulmonary dysplasia (BPD) are two of the most common and serious consequences of prematurity. Synthetic corticosteroids, including dexamethasone, have been central in efforts to treat and prevent BPD. There is strong evidence to show that prenatal corticosteroids reduce infant mortality and the incidence of NRDS, leading to their widespread use in obstetric units...
2018: International Journal of General Medicine
Steffen Kunzmann, Barbara Ottensmeier, Christian P Speer, Markus Fehrholz
The effect of endogenous progesterone and/or exogenous pre- or postnatal progesterone application on lung function of preterm infants is poorly defined. While prenatal progesterone substitution may prevent preterm birth, in vitro and in vivo data suggest a benefit of postnatal progesterone replacement on the incidence and severity of bronchopulmonary dysplasia (BPD). However, the molecular mechanisms responsible for progesterone's effects are undefined. Numerous factors are involved in lung development, airway inflammation, and airway remodeling: the transforming growth factor beta (TGF-β)/mothers against decapentaplegic homolog (Smad) signaling pathway and TGF-β-regulated genes, such as connective tissue growth factor (CTGF), transgelin (TAGLN), and plasminogen activator inhibitor-1 (PAI-1)...
2018: PloS One
Mehmet Buyuktiryaki, Hayriye G Kanmaz, Nilufer Okur, Handan Bezirganoglu, Buse Bekmez, Gulsum Kadioglu Simsek, Fuat E Canpolat, Suna S Oguz, Cuneyt Tayman
BACKGROUND AND OBJECTIVES: It is believed, that sustained lung inflation (SLI) at birth in preterm infants reduces the need for mechanical ventilation (MV) and improves respiratory outcomes. The aim of this study was to compare need for MV in preterm infants at high risk for respiratory distress syndrome (RDS) after prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone. METHODS: Medical records of infants born at 260/7 to 296/7 weeks gestation through 2015 and 2017 were retrospectively assessed...
July 12, 2018: Pediatric Pulmonology
Gustavo Marcondes Rocha, Filipa Flor de Lima, Ana Paula Machado, Hercília Areias Guimarães
INTRODUCTION:  It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants. OBJECTIVE:  To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants. MATERIALS AND METHODS:  Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers...
July 11, 2018: American Journal of Perinatology
Mariane Bertagnolli, Li Feng Xie, Katryn Paquette, Ying He, Anik Cloutier, Rafael Oliveira Fernandes, Chanel Béland, Megan R Sutherland, Jacques Delfrate, Daniel Curnier, Jean-Luc Bigras, Alain Rivard, Bernard Thébaud, Thuy Mai Luu, Anne Monique Nuyt
BACKGROUND: Preterm birth is linked to cardiovascular risks and diseases. Endothelial progenitor cells play a critical role in vascular development and repair. Cord blood endothelial progenitor cells of preterm-born infants, especially endothelial colony-forming cells (ECFC), show enhanced susceptibility to prematurity-related pro-oxidant stress. Whether ECFC dysfunction is present in adulthood following preterm birth is unknown. METHODS AND RESULTS: This cross-sectional observational study includes 55 preterm-born (≤29 gestational weeks) young adults (18-29 years old, 38% male) and 55 sex- and age-matched full-term controls...
July 9, 2018: Journal of the American Heart Association
Tae-Jung Sung, Sook M Hwang, Min Y Kim, Shin G Park, Ka Y Choi
BACKGROUND: To assess the relationship between HRCT abnormalities and the clinical severity of "new" bronchopulmonary dysplasia (BPD) and respiratory assistance in <1500 g preterm infants. METHODS: HRCT was performed at the time of discharge in 109 preterm infants with BPD who were born between 2008 and 2014. BPD severity was defined as mild, moderate, or severe according to the NIH diagnostic criteria. Total HRCT scores for each infant were obtained from the sum of the number of BPD lobes assessed by two radiologists: a hyperaeration score (Hs) composed of decreased attenuation, mosaic attenuation, and bulla/bleb, and a parenchyma score (Ps) composed of linear lesions, consolidation, bronchial wall thickening, and bronchiectasis...
July 6, 2018: Pediatric Pulmonology
Soham Dasgupta, Ashraf M Aly, Michael H Malloy, Anthony O Okorodudu, Sunil K Jain
OBJECTIVE: Pulmonary hypertension (PH) is a known complication of bronchopulmonary dysplasia (BPD). This study aimed to determine the utility of serial N-Terminal pro-Brain Natriuretic Peptide (NTproBNP) levels in the screening of BPD associated PH (BPD-PH) in preterm infants. STUDY DESIGN: Infants with birth weight <1500 g and <30 week corrected gestational age (CGA) were followed with serial NTproBNP levels and echocardiograms (ECHO). They were divided into control, BPD and BPD-PH groups...
July 6, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Jun Luo, Suzanne Shepard, Kathleen Nilan, Audrey Wood, Heather M Monk, Erik A Jensen, Ann T Harrington, Kathryn Maschhoff, Haresh Kirpalani, Zhichun Feng, Huayan Zhang
OBJECTIVES: To examine growth, sedation needs, and participation in developmental activities before and after tracheostomy among infants with severe bronchopulmonary dysplasia. METHODS: Retrospective analysis of infants born at <32 weeks' gestation or birth weights <1500 g with severe BPD who underwent tracheostomy placement between January 1, 2010 and December 31, 2016 in a quaternary referral newborn and infant intensive care unit. Changes in growth parameters and frequency/type of participation in physical therapy sessions performed during the 4-weeks before tracheostomy and 4-weeks after the first tracheostomy tube change were compared...
July 3, 2018: Pediatric Pulmonology
Xian-Xiao Shu, Chao Chen, Jun Tang, Hua Wang
OBJECTIVE: To study the clinical effect and safety of bubble nasal continuous positive airway pressure (BNCPAP) versus conventional nasal continuous positive airway pressure (nCPAP) in respiratory support for preterm infants with neonatal respiratory distress syndrome (NRDS). METHODS: A retrospective analysis was performed for the clinical data of 130 preterm infants with NRDS. Among them, 69 underwent BNCPAP and 61 underwent nCPAP. The two groups were compared in terms of mortality rate, duration of respiratory support, use of pulmonary surfactant (PS), and treatment failure rate, and the incidence rates of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), as well as the changes in blood gas pH, partial pressure of oxygen, and partial pressure of carbon dioxide...
June 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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