PURPOSE: This is a three-year propspective study to describe the characteristics, clinical course and Infant pulmonary function (PFTs) of children with BPD.
METHODS: Children diagnosed with BPD were identified from a teaching hospital neonatal ICU and followed at 3,6,9,12,18,24 and 36 months following discharge. Medical history and physical exam, were obtained each visit. PFTs were performed at 6, 12 and 24 months. Descriptive and correlation data analysis were performed.
RESULTS: 65 children (47% females, 39% Caucasian, 25% Hispanic, 36% African American) were recruited and 31 completed 36 months follow-up. 89% of children were < 28 weeks gestational age and 82% weighed <1000 grams. Cough and wheezing were reported by a significant number of children throughout the study. At 36 months cough was reported by 75% of children,wheezing in 30% and shortness of breath in 28% of children. At 24 months PFT's showed expitarory flow obstruction in 50% of children at 6 and 12 months and 45% at 24 months. Significant bronchodilator response was present in 30%, 23% and 21% of children at 6, 12, 24 months, respectively. This response diminished with time in all children but this was more pronounced in children with severe airway obstruction at baseline (<5th percentile flow).The majority of children with severe obstruction didn't show improvent in their flows over time. Inhaled steroid use correlated inversely with expiratory flow values (P value.037), however, the use of bronchodilators and diuretics did not. Functional residual capacity (FRC) showed a linear increase over time. The use of inhaled steroids positively correlated with FRC values (P=.03), but not the use of oxygen, bronchodilator or diuretics.
CONCLUSION: The majority of current BPD children are very premature with very low birth weight. Pulmonary symptoms continue to be present in a significant number of children over three years with 45% of children showing persistent airway obstruction at 24 months.
CLINICAL IMPLICATIONS: Respiratory symptoms and airflow obstruction continue to be present in a significant number of children with BPD even after three years of life.
DISCLOSURE: Khoulood Fakhoury, None.