Elsevier

The Journal of Pediatrics

Volume 109, Issue 6, December 1986, Pages 1040-1046
The Journal of Pediatrics

Expiratory flow limitation in infants with bronchopulmonary dysplasia

https://doi.org/10.1016/S0022-3476(86)80296-7Get rights and content

We evaluated lung function in 20 infants with bronchopulmonary dysplasia (BPD) during the first year of life. Compared with a group of age- and size-matched controls, the infants with BPD had a significantly (P<0.005) lower functional residual capacity (FRC; 25±4 vs 18±6 ml/kg) at less than 10 1/2 months after conception, but no significant difference during the remainder of the first year. The partial expiratory flow volume curves in the infants with BPD were markedly concave, with tidal breathing approaching expiratory flow limitation. The infants with BPD had significantly (P<0.01) lower absolute and size-corrected flows than did control infants, and 50% of the infants with BPD required rehospitalization because of acute respiratory distress associated with a lower respiratory tract illness. In addition, the slope of the linear regression of maximal expiratory flow at FRC (in milliliters per second) vs length (in centimeters) was significantly lower (P<0.001) for the infants with BPD than for normal control infants (2.25 vs 4.52), Indicating poor growth of the airways. Oxygen saturation (Sao2 was negatively correlated with maximal expiratory flow at FRC, indicating that measurement of Sao2 alone may not be sufficient in the evaluation of lung function in infants with BPD. We conclude that, although infants with BPD improve clinically during the first year of life, they have abnormal functional airway growth; the decreased expiratory flow reserve helps to explain their high risk for acute respiratory distress during lower respiratory tract lliness.

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    1

    Supported by Grant HL 14136(SCOR) and by Clinical Investigator Grants K08-HL0-1322 (R.S.T.) and K08-HL0-1377 (W.J.M.) from the National Heart, Lung, and Blood Institute.

    2

    Dr. Tepper is the recipient of an American Lung Association Clinical Fellowship.

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