BPD - Pulmonary
Introduction Pathogenesis Clinical Prevention Management Prognosis Growth Cardiovascular Pulmonary Neurodevelopmental Mortality References Abbreviations Other Lectures		Short-term follow-up studies of pulmonary function on babies with a history of BPD have shown that measures of lung volume, including compliance and FRC increase to normal by age 3. However, resistance is still 30% above normal at that age and in many babies remains so for some time. Longer follow-up studies have shown that the pulmonary function abnormalities usually improve by school age, most patients have normal exercise tolerance by late childhood and most of the pulmonary function abnormalities resolve by early adulthood. However, those with severe BPD can have abnormal pulmonary function for years. The degree of pulmonary impairment correlates with the need for oxygen. Northway himself reported on his original cohort of babies from 1967, followed at age 18. Hyperinflation was frequent, 50% had reactive airway disease and 2/3 had evidence of airway obstruction. These same findings have consistently been found in all long-term follow-up studies: hyperinflation, bronchial hyperreactivity and airway obstruction. BPD babies have twice the risk of developing wheezing/asthma by mid-childhood as other non-BPD premies. And 50% of BPD babies have been shown to have laboratory evidence of bronchial hyperreactivity, even those without a clinical history of wheezing or asthma. All of the above applies primarily to babies with classic BPD. There is almost no data on long-term pulmonary function follow-up of babies from the post-surfactant era. However, because of the large number of babies with continued abnormal pulmonary function, BPD babies would seem to be at risk for chronic obstructive lung disease (COPD) in adulthood. One of the most important things the pediatrician can do is counsel the patients about the hazards of cigarette smoking and the families about the risks to the patient of secondhand smoke in the home. Return to top of page