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Perinatal medicine

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G/TUES/PER1 EVOLUTION OF LUNG FUNCTION ABNORMALITIES IN INFANTS DEVELOPING MILD OR MODERATE/SEVERE BRONCHOPULMONARY DYSPLASIA

C. May, C. Kennedy, G. Rafferty, A. Greenough.Division of Asthma, Allergy and Lung Biology, King’s College London, London, UK

Background: Nowadays, very prematurely born infants, who are chronically oxygen dependent, may have a maldevelopment sequence resulting from interference/interruption of normal developmental signalling for terminal maturation and alveolarisation of the lungs rather than the injury/repair paradigm of traditional BPD.1 How this affects their lung function and whether the severity of BPD influences any lung function abnormalities remain to be determined.

Objective: To test the hypothesis that particularly infants with moderate/severe BPD will have low lung volumes throughout the neonatal period reflecting abnormal antenatal lung growth.

Methods: Serial lung function measurements (compliance (CRS) and resistance (RRS) of the respiratory system by single breath mechanics and lung volume assessed by measurement of functional residual capacity (FRC) using a helium gas dilution technique) were attempted on days 3, 5, 7, 14, 21 and 28 after birth.

Patients: Sixty five infants, median gestational age 29 (range 24–32) weeks were studied. 27 infants had BPD: 8 had mild BPD, that is they were oxygen dependent at 28 days but not 36 weeks PMA and 19 had moderate/severe BPD, that is they were oxygen dependent at 36 weeks PMA.

Results: The infants with BPD compared to the infants without BPD had significantly lower FRCs throughout the neonatal period (p<0.01) and initially had lower CRS results (p = 0.004), but subsequently their CRS results improved such that there was no significant difference in the median CRS of the two groups at day 28. In contrast, the median RRS results did not differ significantly by BPD status on day three, but the RRS results of the BPD infants remained elevated throughout the neonatal period; as a consequence, they had significantly higher RRS results compared to the infants without BPD …

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