Pulmonary function until two years of life in infants with bronchopulmonary dysplasia
Pulmonary function until two years of life in infants with bronchopulmonary dysplasia
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DOI：
10.1164/ajrccm.155.1.9001304
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发表时间：
1997-01-01
影响因子：
24.7
通讯作者：
Zacchello, F
中科院分区：
文献类型：
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作者：
Baraldi, E;Filippone, M;Zacchello, F
为了评价出生时体重小于1,250 g的支气管肺发育不良（BPD）婴儿肺功能的生理过程，对24例BPD婴儿从出生到2岁进行了一系列肺功能评价。所有婴儿在出生时均进行插管，机械通气的平均持续时间为38 +/- 4 d。被动呼吸系统顺应性（Crs）和阻力（Rrs）在10和20天的生活在机械通气。此后，在出生后3、6、9、12和24个月时评价肺力学和功能残气量（FRC）。在2岁时测量用力呼气流量（Vmax，FRC）。在BPD急性期发现Crs（预测值的50%）的严重改变，与Rrs的异常值相关。在出生后的第一年，Crs和Rrs逐渐改善（ANOVA，p < 0.0001），在24个月龄时，Crs和Rrs达到正常范围。3个月时FRC值为预测值的86 +/- 7.5%，并逐渐增加至2岁时预测值的平均值115 +/- 5%。尽管在2年评价中阻力时间过程良好，但发现Vmax、FRC的数据不太有利，70%的儿童个体值降低超过预测值的40%。总之，尽管BPD幸存者的肺力学在生命的最初几年有所改善，达到正常值的范围，但在2岁时，他们仍然存在大量的气道功能障碍，表现为低用力呼气流量。
To evaluate the physiologic course of pulmonary function in infants with bronchopulmonary dysplasia (BPD) weighing less than 1,250 g at birth, 24 infants with BPD underwent serial pulmonary function evaluations from birth until 2 yr of age. All infants were intubated at birth and the mean duration of mechanical ventilation was 38 +/- 4 d. Passive respiratory system compliance (Crs) and resistance (Rrs) were measured between 10 and 20 d of life during mechanical ventilation. Thereafter pulmonary mechanics and functional residual capacity (FRC) were evaluated at 3, 6, 9, 12, and 24 mo of postnatal age. Forced expiratory flow (Vmax,FRC) was measured at 2 yr of age. A severe alteration on Crs (50% of predicted) was found during the acute phase of BPD, associated with abnormal values of Rrs. A progressive improvement (ANOVA, p < 0.0001) occurred in the first year of life and, at 24 mo of age, Crs and Rrs reached the range of normalcy. FRC value was 86 +/- 7.5% of predicted at 3 mo and gradually increased to a mean value of 115 +/- 5% of predicted at 2 yr of age. In spite of the good resistance time course over the 2-yr evaluation, less favorable data of Vmax,FRC were found with individual values reduced more than 40% of predicted values in 70% of the children. In conclusion, although pulmonary mechanics of BPD survivors improves during the first years of life, reaching the range of normal values, at 2 yr of age they still present a substantial airway function impairment as revealed by the low forced expiratory flows.