RT Journal Article
SR Electronic
T1 Chest radiographic thoracic area and severity of bronchopulmonary dysplasia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 279
VO 44
IS Suppl 58
A1 Theodore Dassios
A1 Anna Curley
A1 Zoltan Molnar
A1 Leo Thanikkel
A1 Colin Morley
A1 Robert Ross-Russell
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/279.abstract
AB Background: Established bronchopulmonary dysplasia (BPD) is characterised by increased lung volume secondary to hyperinflation and ventilation inhomogeneity. BPD severity can be quantified by measuring ventilation/perfusion (V/Q) inequality. We hypothesised that chest radiographic thoracic area (CRTA) in established BPD, is significantly related to severity of BPD assessed by V/Q inequality.Measures: We studied 16 infants receiving respiratory support with BPD (defined as receiving oxygen at 28 days), in a tertiary UK Neonatal Unit. Fraction of inspired oxygen (FiO2) was altered to vary transcutaneous oxygen saturation (SpO2) between 88% and 96%. V/Q ratio was derived using a computer algorithm by plotting and analysing at least three pairs of FiO2 and SpO2 for each infant (Quin D. Arch Dis Child2006;91:F409–F414). CRTA was measured by free hand tracing the perimeter of the thoracic area in anterio-posterior chest radiographs obtained within 48 hrs of V/Q measurement.Results: Median (IQR) gestational age was 26(24–27) weeks and postnatal age was 48(30-68) days. CRTA/kg [2495 (2006-2807) cm2] was significantly related to V/Q ratio (r=-0.604, p=0.022), the pH of the last gas (r=-0.767, p=0.016) and the average FiO2 on the day prior to measurement (r=0.575, p=0.032).Conclusions: Hyperinflation in BPD can be assessed simply by measuring CRTA. CRTA in BPD is significantly related to disease severity as quantified by V/Q inequality and FiO2. This program can be used as a simple radiographic test to quantify BPD severity.