[Bronchopulmonary dysplasia -- early and long-term pulmonary sequelae]

Abstract

Improvement in perinatal care have resulted in significantly increased survival of premature infants. Discontinuation of correct intrauterine lung development and a necessity of oxygen-therapy and/or mechanical ventilation become a reason of bronchopulmonary dysplasia (BPD). In the first period of life the main complaint of these patients is oxygen dependence. Moreover the risk of serious infections of lower respiratory tract (particularly RSV) increases. This becomes the reason of readmission of about 50% prematures with diagnosed BPD in the first year of life. The main problem of these patients is airway obstruction, which very often doesn't respond to brochodilatators. The probable reason of these disturbances is imperfect development of respiratory system and remodelling of respiratory tract. Reduction in lung function (reduced FEV(1), PEF, FVC) persists until adolescence. Acceleration of the decrease in FEV(1)/FVC ratio may suggest that these patients are a risk group of COPD development. The assessment of lung radiography at the age of 11 years of former prematures with diagnosed BPD reveals the presence of persistent emphysematic changes (86% of these children had one or more bubbles). Abnormalities in chest high resolution CT occur in the majority of these patients (in 81.3% of the 10-years-olds group and in 92.5% of 18-year-olds group). Further prospective long-term study of prematures is essential for the establishment of remote prognosis and treatment standards.