Email this article 
Post a Comment Apnea within the first year of life in premature infants with bronchopulmonary displasia and pulmonary hypertension
- Authors: Solomakha A.Y.1, Petrova N.A.1, Ivanov D.O.2, Sviryaev Y.V.1
-
Affiliations:
- Almazov National Medical Research Center
- St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
- Issue: Vol 9, No 3 (2018)
- Pages: 16-23
- Section: Articles
- URL: https://journals.rcsi.science/pediatr/article/view/9127
- DOI: https://doi.org/10.17816/PED9316-23
- ID: 9127
Cite item
Abstract
Infants with severe and moderate bronchopulmonary dysplasia (BPD) are characterized by long-term persistence of apnea of prematurity and often have a pulmonary hypertension (PH). Respiratory pauses, accompanied by intermittent hypoxia, do not clinically manifest themselves, therefore cardiorespiratory monitoring (CRM) is required. We hypothesized that the persistent of apnea, as the cause of hypoxemia episodes, may be associated with the persistence of PH in infants with BPD.
The aim of the study was to evaluate the dynamics of cardiorespiratory parameters and to study the relationship between obstructive apnea and PH during the first year of life of premature infants with BPD + PH.
Materials and methods. CRM was performed in 58 infants were born at 26 0/7-31 0/7 weeks gestation and with birth weight less than 1500 grams, before discharge from the hospital (35-44 weeks of post menstrual age). 14 infants did not have BPD (group without BPD). 44 infants had BPD and 17 of them had a complication of this disease PH (BLD + PH group). Other infants with BPD did not have PH (BLD-PH group). Eight infants with BPD also underwent a study at home (aged 9 to 10 months of life).
Results. Preterm infants with BPD + PH were more significant decrease in the average SpO2, higher desaturation index and more a number of desaturation episodes of <10% compared to infants with BPD-PH and without BPD. There was no difference in the apnea/hypopnea index and frequency of occurrence of different types of apnea between groups. There was no difference in cardiorespiratory performance in infants with BPD+PH compared to infants with BPD-PH in 9-10 months of life.
Conclusions. There was a positive dynamics of cardiorespiratory parameters in infants with BPD+PH in 9-10 months after discharge from the hospital. The number of infants with an index of OA> 1/hour is higher in the group BPD+LH.
Full Text
##article.viewOnOriginalSite##About the authors
Anna Yu. Solomakha
Almazov National Medical Research Center
Author for correspondence.
Email: anka.solomaha@yandex.ru
MD, Post-Graduate Student, Pediatrician, Department of Pediatric Diseases
Russian Federation, Saint PetersburgNatalia A. Petrova
Almazov National Medical Research Center
Email: natalja5@yandex.ru
MD, PhD, Neonatologist, Head of Physiology and Pathology of Newborns Laboratory
Russian Federation, Saint PetersburgDmitry O. Ivanov
St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Email: doivanov@yandex.ru
MD, PhD, Dr Med Sci, Professor, Rector
Russian Federation, Saint PetersburgYurii V. Sviryaev
Almazov National Medical Research Center
Email: yusvyr@yandex.ru
MD, PhD, Dr Med Sci, Cardiologist, Head of Sleep Medicine Laboratory
Russian Federation, Saint PetersburgReferences
- Геппе Н.А., Розинова Н.Н., Волков И.К., и др. Новая рабочая классификация бронхолегочных заболеваний у детей // Доктор.Ру. - 2009. - № 1. - С. 7-13. [Geppe NA, Rozinova NN, Volkov IK, et al. New working classification of bronchopulmonary diseases in children. Doktor.ru. 2009;(1):7-13. (In Russ.)]
- Овсянников Д.Ю. Бронхолегочная дисплазия у детей первых трех лет жизни: Автореф. дис. … д-ра мед. наук. - М., 2010. [Ovsyannikov DY. Bronchopulmonary dysplasia in children of the first three years of life. [dissertation] Moscow; 2010. (In Russ.)]
- Петрова Н.А. Особенности регуляции дыхания у новорожденных детей с формирующейся хронической бронхолегочной патологией: Автореф. дис. … канд. мед. наук. - СПб., 2010. [Petrova NA. Features of the regulation of respiration in newborn children with developing chronic bronchopulmonary pathology. [dissertation] Saint Petersburg; 2010. (In Russ.)]
- Abman SH, Hansmann G, Archer SL, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation. 2015;132(21):2037-2099. doi: 10.1161/CIR.0000000000000329.
- Al-Ghanem G, Shah P, Thomas S, et al. Bronchopulmonary dysplasia and pulmonary hypertension: a meta-analysis. J Perinatol. 2017;37(4):414-419. doi: 10.1038/jp.2016.250.
- Ambalavanan N, Mourani P. Pulmonary hypertension in bronchopulmonary dysplasia. Birth Defects Res A Clin Mol Teratol. 2014;100(3):240-246. doi: 10.1002/bdra.23241.
- Amin SB, Burnell E. Monitoring apnea of prematurity: validity of nursing documentation and bedside cardiorespiratory monitor. Am J Perinatol. 2013;30(8):643-8. doi: 10.1055/s-0032-1329694.
- Barrington K, Finer N. The natural history of the appearance of apnea of prematurity. Pediatr Res. 1991;29(4 Pt 1):372-375. doi: 10.1038/pr.1991.72500.
- Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8(5):597-619. doi: 10.5664/jcsm.2172.
- Bixler EO, Vgontzas AN, Lin HM, et al. Sleep disordered breathing in children in a general population sample: prevalence and risk factors. Sleep. 2009;32(6):731-6. doi: 10.1093/sleep/32.6.731.
- Blencowe H, Cousens S, Chou D, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10 Suppl 1:S2. doi: 10.1186/1742-4755-10-S1-S2.
- Network SSGotEKSNNR, Carlo WA, Finer NN, et al. Target ranges of oxygen saturation in extremely preterm infants. N Engl J Med. 2010;362(21):1959-1969. doi: 10.1056/NEJMoa0911781.
- Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723-1729. doi: 10.1164/ajrccm.163.7.2011060.
- Katz ES, Mitchell RB, D’Ambrosio CM. Obstructive sleep apnea in infants. Am J Respir Crit Care Med. 2012;185(8):805-816. doi: 10.1164/rccm.201108-1455CI.
- Khemani E, McElhinney DB, Rhein L, et al. Pulmonary artery hypertension in formerly premature infants with bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era. Pediatrics. 2007;120(6):1260-9. doi: 10.1542/peds.2007-0971.
- Kicinski P, Kesiak M, Nowiczewski M, Gulczynska E. Bronchopulmonary dysplasia in very and extremely low birth weight infants - analysis of selected risk factors. Pol Merkur Lekarski. 2017;42(248):71-75.
- Marcus CL, Brooks LJ, Draper KA, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):e714-755. doi: 10.1542/peds.2012-1672.
- McCoy JG, McKenna JT, Connolly NP, et al. One week of exposure to intermittent hypoxia impairs attentional set-shifting in rats. Behav Brain Res. 2010;210(1):123-6. doi: 10.1016/j.bbr.2010.01.043.
- McEvoy CT, Jain L, Schmidt B, et al. Bronchopulmonary dysplasia: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases. Ann Am Thorac Soc. 2014;11 Suppl 3:S146-153. doi: 10.1513/AnnalsATS.201312-424LD.
- Montgomery-Downs HE, Young ME, Ross MA, et al. Sleep-disordered breathing symptoms frequency and growth among prematurely born infants. Sleep Med. 2010;11(3):263-267. doi: 10.1016/j.sleep.2009.06.007.
- Moyer-Mileur LJ, Nielson DW, Pfeffer KD, et al. Eliminating sleep-associated hypoxemia improves growth in infants with bronchopulmonary dysplasia. Pediatrics. 1996;98(4 Pt 1):779-783.
- Venkata N, Buhary M, Munyard P. Persistent pulmonary hypertention of the newborn (PPHN) neonatal clinical guideline. [Internet]. Treliske, UK: Royal Cornwall Hospital; 2015. Available from: http://www.rcht.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/Neonatal/PERSISTENTPULMONARYHYPERTENSIONOFTHENEWBORN.pdf.
Supplementary files
