[Pulmonary sequelae of long-term ventilation of very low birth weight premature infants. Results of a follow-up study of 6-to-9-year-old children].
Fifty six children with a birth weight of less than 1500 g and gestational age less than 34 weeks were studied at a mean age of 7.7 years. All had required mechanical ventilation, 36 suffered from hyaline membrane disease, 17 from atelectasis and three from pneumonia. Of these patients 37 developed broncho-pulmonary dysplasia (BPD). The study included skin prick test, measurement of ciliary beat frequency, chest X-ray, whole-body plethysmography and histamine challenge. Eight patients suffered from recurrent pulmonary infections up to the age of 4 years. Eleven children had a positive skin prick test. Three suffered from allergic asthma and six from hay-fever. The family history of atopy in these premature infants was no different from that of the general population. Ciliary beat frequency was normal in all cases (frequency: 11.8 +/- 1.8 Hz). In 34 patients X-rays showed minimal changes (peribronchial thickening n = 6, mild emphysema n = 28). Pulmonary function was normal except for an increase of thoracic gas volume which was correlated to grade of BPD according to Northway. There was a significant correlation between oxygen-score and radiological stage of BPD (r = 0.7). Histamine challenge showed hyperresponsiveness in 53% of the children. Eight patients showed a threshold similar of mild asthma (less than 1000 micrograms histamine per ml). The degree of airway hyperreactivity was correlated to the grade of BPD (r = 0.7; p less than 0.01) and the oxygen-score (r = -0.63; p less than 0.05). The oxygen-score may be considered a predictor of hyperresponsiveness and pulmonary outcome in later childhood.
Zentrum der Kinderheilkunde, Johann Wolfgang Goethe-Universität, Frankfurt/Main.
P
P
Ahrens
S
S
Zielen
B
B
Stöver
V
V
von Loewenich
D
D
Hofmann
D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000209:etiology; D001997:Bronchopulmonary Dysplasia / Q000209:etiology* / Q000628:therapy; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D006819:Hyaline Membrane Disease / Q000628:therapy; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007385:Intermittent Positive-Pressure Ventilation / Q000009:adverse effects; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D012882:Skin Tests
Die pulmonalen Folgen der Langzeitbeatmung von very low birth weight Frühgeborenen. Ergebnisse einer Nachuntersuchung der Kinder im Alter von 6-9 Jahren.