Analysis of BPD in Premature Infants With Typical Imaging Changes

Clinical Characteristics and Outcome Analysis of Bronchopulmonary Dysplasia in Premature Infants With Typical Imaging Changes

Bronchopulmonary dysplasia (BPD) is a common respiratory disease in premature infants, the incidence of which is increasing in recent years. It seriously affects the survival rate and quality of life of premature infants. At present, the diagnosis of BPD mainly adopts the 2001 NICHD standard, which does not account for the radiographic information. However, some recent studies revealed that the BPD infants with fibrotic and cystic radiographic changes required longer-term invasive ventilation, longer-term parenteral nutrition, more frequent red blood transfusion and a higher risk of home oxygen therapy. The infants with moderate or several BPD were also reported to be more likely to have a radiographic appearance with fibrosis or cysts than those with mild BPD. The radiographic patterns of BPD were stratified into four stages according to the lung pathology. The fibrotic and cystic patterns were defined as the typical changes of BPD, which is commonly present at 10 days or later after birth. However, it is not uncommon to occur earlier. One study reported that 23%?27% of infants with moderate or severe BPD had typical radiograph changes on the first day of life. The exact etiology of early fibrotic and cystic changes is little known, which is likely to be associated with intrauterine inflammation. Chorioamnionitis and intrauterine infection was believed to induce fetal lung inflammation, which could interfere with lung development, resulting in BPD. Therefore, early radiographic fibrotic and cystic appearance may indicate a specific stage of lung inflammation, which originates in the intrauterine infection and subsequently develop BPD. Currently, BPD is diagnosed solely based on oxygen dependence, which does not reflect the etiology and pathogenesis. It can be speculated that BPD may have different subgroups; each subgroup could have unique etiology, clinical and radiographic patterns, and prognosis. The BPD with early fibrotic and cystic radiographic changes is likely to be a particular subgroup, which is likely to be attributable to intrauterine infection. Therefore, this retrospective study aims to depict the clinical profiles and prognosis of BPD infants with early typical radiographic changes, which will be of great potential for early-adopting tailored management and improving the long-term outcome of this group of infants.

Analysis of BPD in Premature Infants With Typical Imaging Changes

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