Late sudden unexpected deaths in hospitalized infants with bronchopulmonary dysplasia

Article Abstract:

Bronchopulmonary dysplasia (BPD) refers to abnormal function of the heart or lungs following oxygen and ventilation therapy in newborns who were born with respiratory failure. Although most newborns with BPD survive neonatal intensive care and eventually develop improved lung functioning, many continue to have health problems or do not survive. The sudden death of a stable or improving infant is one cause of mortality in infants with BPD. To determine the risk factors for early and late sudden death, the charts of 348 infants who required assisted ventilation were evaluated. Of 88 infant deaths, 77 (88 percent) occurred during the first 30 days of life. Sudden unexpected deaths were reported in 7 of 11 infants who received assisted (mechanical) ventilation for more than 60 days. The infants were an average of one year old, with an age range of 4 to 27 months, and were improving clinically at the time of death. The deaths were unrelated to any clinical event and occurred even when resuscitative efforts were employed rapidly. Assisted ventilation was still being used for four infants, and four additional infants had tracheostomies (a surgical opening in the airway or windpipe). Although the actual cause of death is unknown, heart enlargement or prolonged use of medications, such as theophylline and beta-adrenergic agonists, often preceded the deaths. Late sudden death is a significant cause of mortality in infants with BPD who required ventilation for longer than two months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Infants (Newborn), Newborn infants, Sudden death, Ventilators, Ventilators (Medical equipment)

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Energy intake, growth, and development in ventilated very-low-birth-weight infants with and without bronchopulmonary dysplasia

Article Abstract:

As technological improvements have been made in recent years, the rate of survival of very-low-birth-weight infants has increased significantly. But the infants that survive often have serious medical conditions. One of the more frequently observed complications in these infants is bronchopulmonary dysplasia (BPD). This condition, abnormal tissue growth in the bronchi and lungs, arises as a result of artificial respiration (ventilation) which is frequently used to keep these infants alive. This study examined 71 very-low-birth-weight infants born between one and three pounds, who required artificial respiration. Of this group, 30 developed BPD and 41 did not. The growth, nutritional status, and development of these two groups were compared. Half of the infants with BPD developed major and minor handicaps compared with 37 percent of the infants without BPD. The handicapped infants received artificial respiration for a longer period of time, on average, than the nonhandicapped infants; it was concluded that duration of artificial respiration was associated with handicaps. When growth measurements of the two groups were taken at one year and again at 21 months, no correlations were found between abnormal neurodevelopment and head circumference, weight, or length. Delayed growth was more common among handicapped infants than among infants without handicaps. Neurological outcome did not appear to be influenced by aggressive nutritional support. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Infants (Premature), Birth weight, Low, Premature infants, Low birth weight, Growth, Pediatric neurology

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Gastroesophageal reflux to the proximal esophagus in infants with bronchopulmonary dysplasia

Article Abstract:

Gastroesophageal reflux (GER), the backflow of stomach contents into the esophagus, is responsible for many respiratory diseases in children, including pneumonia, breathing stoppage (apnea), asthma, and bronchitis (swelling in the bronchial tree). Although the mechanism is not well understood, it is thought that breathed-in stomach contents stimulate the receptors in the esophagus to cause spasms in the bronchial tree. Bronchopulmonary dysplasia (BPD) is a disease in infants characterized by abnormal tissue growth in the breathing structures, sometimes necessitating mechanical breathing devices. Children with bronchopulmonary dysplasia show improvement with treatment given for gastroesophageal reflux, even when GER has not been confirmed. GER tends to aggravate existing lung disease. To determine the frequency of gastroesophageal reflux in children with BPD, 14 children with the condition and 13 infants without BPD were studied. The acid content in the esophagus was measured with a probe to diagnose GER. Children with BPD had fewer episodes of GER, which lasted a shorter amount of time. Therefore a true diagnosis of GER cannot be made in children with BPD. Although it is difficult to draw conclusions from this small study, GER is either insignificant in some children with BPD or else periodic episodes contribute to existing lung disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gastroesophageal reflux in children, Pediatric gastroesophageal reflux, Lung diseases, Pediatric respiratory diseases

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