Abstract
Summary: Pulmonary function tests were performed in two groups of infants with bronchopulmonary dysplasia; a group less than 7 months of age with severe ventilator-dependent respiratory failure (Group A), and a group 7–22 months of age during resolution of their disease (Group B). Group A patients had significantly elevated minute volume, low specific compliance, elevated inspiratory and expiratory pulmonary resistance, and low functional residual capacity. Group B patients also demonstrated elevated minute volume, whereas specific compliance, inspiratory pulmonary resistance and functional residual capacity were within normal limits, and expiratory pulmonary resistance was only slightly above normal. With the exception of minute volume, the differences between the groups were significant (P < 0.05). Sequential studies of resistance and compliance over 4–5 months in two patients in the younger group demonstrated values that approached or achieved normal range. It is concluded that pulmonary mechanics improve with age in the infant with severe bronchopulmonary dysplasia.
Speculation: The high minute ventilation demonstrated in children with branchopulmonary dysplasia results from increased dead space ventilation. With low compliance and high resistance the young infant cannot sustain the high minute ventilation required, and respiratory failure ensues, requiring mechanical ventilation. As the child grows, chest wall strength, compliance, and resistance improve, allowing the infant to sustain a high spontaneous minute ventilation, and thus to tolerate gradual reduction and eventual removal of mechanical ventilatory support.
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Morray, J., Fox, W., Kettrick, R. et al. Improvement in Lung Mechanics as a Function of Age in the Infant with Severe Bronchopulmonary Dysplasia. Pediatr Res 16, 290–294 (1982). https://doi.org/10.1203/00006450-198204000-00009
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DOI: https://doi.org/10.1203/00006450-198204000-00009
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