Affiliations: [a] Department of Neonatology, ChristianaCare. Newark DE, USA
| [b] Institute for Research on Equity and Community Health (iREACH), ChristianaCare, Newark, DE, USA
| [c] Nemours Biomedical Research, Nemours Children’s Health, Wilmington, DE, USA
| [d] Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| [e] Department of Physiology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
Correspondence:
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Address for correspondence: Kelley Kovatis, ChristianaCare Health System, Women and Children’s Center, 4755 Ogletown Stanton Road, Garden Level, Newark, DE 19713, USA. Tel.: +1 301 301 2410; E-mail: Kelley.kovatis@christianacare.org.
Abstract: BACKGROUND:Thoracoabdominal asynchrony (TAA) is commonly seen in preterm infants. Respiratory inductive plethysmography (RIP) is a noninvasive way to objectively assess work of breathing (WOB) indices. The impact of bronchopulmonary dysplasia (BPD) on TAA at discharge has not been established. The aim of this study is to compare WOB indices in premature infants with a diagnosis of BPD to premature infants without a diagnosis of BPD at discharge. METHODS:A prospective, observational study of premature infants (<32 weeks gestation) at discharge during quiet breathing in the supine position. RIP noninvasively measured WOB indices. A high-resolution pulse oximeter collected oxygen saturation and heart rate data. RESULTS:This study included thirty-one infants with BPD and thirty-four infants without BPD. Infants diagnosed with BPD had increased phase angle [BPD Φ = 73 . 90 (8.2) vs NoBPD Φ = 52.6 (8.2), p = 0.039]. Infants diagnosed with BPD had decreased saturations [BPD SpO2 = 96% (0.4) vs NoBPD Sp02 98% (0.3), p=<0.001], increased time with saturations less than 85% [BPD % =2.74 (0.7) vs NoBPD % =0.91 (0.4), p = .018], and increased time with saturations less than 80% [BPD % =1.57 (0.5) vs NoBPD % =0.52 (0.3), p = 0.045]. There was no difference in heart rate or breaths per minute for infants with BPD versus controls. CONCLUSION:Premature infants with BPD demonstrated increased TAA and had lower saturations compared to infants without BPD at discharge despite being chronologically older and being discharged at an older corrected gestational age. The impact of BPD on breathing patterns persists at discharge and suggests these patients may have residual lung and/or respiratory muscle dysfunction.
Keywords: Bronchopulmonary dysplasia, plethysmography, premature infants, respiratory inductive, work of breathing
