Readmission of children with bronchopulmonary dysplasia in the first 2 years of life:a clinical analysis of 121 cases
YOU Jing-Yi, SHU Chang, GONG Cai-Hui, LIU Sha, FU Zhou
Department of Respiratory Diseases, Children's Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing 400014, China
Abstract：Objective To investigate the clinical features of readmitted children with bronchopulmonary dysplasia (BPD) in the first 2 years of life. Methods A retrospective analysis was performed for the clinical data of 242 children with BPD who were readmitted due to recurrent lower respiratory tract infection (LRTI) in the first 2 years of life. Results Among all the 242 children with BPD, 115 (47.5%) had wheezing, and the children aged 1-2 years had a significantly higher incidence rate of wheezing than those aged less than 1 year (P < 0.05). Chest imaging was performed for 193 children, among whom 31 (16.1%) had hyperlucent areas. Pulmonary function examination showed that the BPD children had significantly lower TV/kg, TPEF/TE, VPEF/VE, TEF50 and TEF75, and significantly higher respiratory rate than the controls without respiratory disease (P < 0.05). Bronchoscopy was performed for 28 children, among whom 21 (75%) had airway dysplasia. All the 242 children used inhaled corticosteroids (ICS) and experienced no treatment-related adverse reactions. Six children were given intravenous infusion of human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) and experienced no infusion-related events or adverse reactions, among whom one child successfully stopped oxygen therapy. Conclusions The incidence rate of wheezing increases with the increase in age in children with BPD who are readmitted due to LRTI. Pulmonary function examination shows small airway obstruction, reduced expiratory flow rate in case of low lung capacity, and increased respiratory rate, and most children have airway dysplasia. ICS can be used to inhibit inflammatory response in the acute stage. Infusion of hUCB-MSCs is safe and feasible and may bring some benefits to the recovery from BPD.
YOU Jing-Yi,SHU Chang,GONG Cai-Hui et al. Readmission of children with bronchopulmonary dysplasia in the first 2 years of life:a clinical analysis of 121 cases[J]. CJCP, 2017, 19(10): 1056-1060.
McEvoy CT, Jain L, Schmidt B, et al. Bronchopulmonary dysplasia:NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases[J]. Ann Am Thorac Soc, 2014, 11(Suppl 3):S146-S153.
[2]
Day CL, Ryan RM. Bronchopulmonary dysplasia:new becomes old again![J]. Pediatr Res, 2017, 81(1-2):210-213.
[3]
Morrow LA, Wagner BD, Ingram DA, et al. Antenatal determinants of bronchopulmonary dysplasia and late respiratory disease in preterm infants[J]. Am J Respir Crit Care Med, 2017, 196(3):364-374.
Collaco JM, Aherrera AD, McGrath-Morrow SA. The influence of gender on respiratory outcomes in children with bronchopulmonary dysplasia during the first 3 years of life[J]. Pediatr Pulmonol, 2017, 52(2):217-224.
[8]
Gortner L, Shen J, Tutdibi E. Sexual dimorphism of neonatal lung development[J]. Klin Padiatr, 2013, 225(2):64-69.
Lavoie TL, Krishnan R, Siegel HR, et al. Dilatation of the constricted human airway by tidal expansion of lung parenchyma[J]. Am J Respir Crit Care Med, 2012, 186(3):225-232.
