Pulmonale Langzeitfolgen der bronchopulmonalen Dysplasie

Zusammenfassung

Die bronchopulmonale Dysplasie (BPD) stellt eine der bedeutendsten Komplikationen der Frühgeburtlichkeit dar. Sie ist nach wie vor die häufigste chronische Lungenerkrankung im Kleinkindesalter. Frühgeborene mit BPD können bis ins Erwachsenenalter hinein unter pulmonalen Einschränkungen wie Atemwegsobstruktion und Überblähung sowie persistierenden respiratorischen Beschwerden leiden. Frühgeborene aus der Surfactant-Ära scheinen gleichermaßen von den Langzeitfolgen der BPD betroffen zu sein. Unklar ist, ob ein mögliches besseres Langzeitoutcome durch das Überleben von immer unreiferen Frühgeborenen verdeckt wird. Beim Management von Patienten mit chronischer Lungenerkrankung nach BPD sollte auf eine Abgrenzung zum Asthma bronchiale geachtet werden. Bisher konnte kein positiver Effekt einer Therapie mit inhalativen Steroiden beobachtet werden. Die Anwendung von inhalativen Bronchodilatatoren wird bisher nur bei Anzeichen einer reversiblen Atemwegsobstruktion oder Exazerbationen empfohlen.

Summary

Bronchopulmonary dysplasia (BPD) is one of the major complications of premature birth. It is still the most common chronic lung disease in infancy. Prematurely born infants often suffer until adulthood of respiratory limitations such as airway obstruction, air trapping and persistent respiratory symptoms. Patients born in the surfactant era seem to be equally affected by the long term sequels of BPD. So far it is uncertain if a better long term outcome might be masked by the survival of more immature infants. Chronic lung disease following BPD should be distinguished from asthma regarding management of patients. So far no benefit from the treatment with inhaled corticosteroids was observed. The application of inhaled bronchodilators is only recommended in the case of a reversible airway obstruction or acute exacerbations.

Schlüsselwörter

Bronchopulmonale Dysplasie - Lungenfunktion - Frühgeburtlichkeit

Keywords

Bronchopulmonary dysplasia - lung function - premature birth

• Literatur

• 1 Abman S, Davis JM. Bronchopulmonary dysplasia. Chernick V, Boat TF, Wilmott RW, Bush A. Kendig’s disorders of the respiratory tract in children. 7. Aufl. Philadelphia: Saunders/Elsevier; 2006: 342-358.
• 2 Allen J, Zwerdling R, Ehrenkranz R. et al. Statement on the care of the child with chronic lung disease of infancy and childhood. Am J Respir Crit Care Med 2003; 168 (03) 356-396.
• 3 Bader D, Ramos AD, Lew CD. et al. Childhood sequelae of infant lung disease: exercise and pulmonary function abnormalities after bronchopulmonary dysplasia. J Pediatr 1987; 110 (05) 693-699.
• 4 Bancalari E, Claure N, Sosenko IR. Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition. Semin Neonatol 2003; 8 (01) 63-71.
• 5 Baraldi E, Bonetto G, Zacchello F, Filippone M. Low exhaled nitric oxide in school-age children with bronchopulmonary dysplasia and airflow limitation. Am J Respir Crit Care Med 2005; 171 (01) 68-72.
• 6 Baraldi E, Filippone M. Chronic lung disease after premature birth. N Engl J Med 2007; 357 (19) 1946-1955.
• 7 Baraldi E, Filippone M, Trevisanuto D. et al. Pulmonary function until two years of life in infants with bronchopulmonary dysplasia. Am J Respir Crit Care Med 1997; 155 (01) 149-155.
• 8 Bland RD. Neonatal chronic lung disease in the post-surfactant era. Biol Neonate 2005; 88 (03) 181-191.
• 9 Blayney M, Kerem E, Whyte H, O’Brodovich H. Bronchopulmonary dysplasia: improvement in lung function between 7 and 10 years of age. J Pediatr 1991; 118 (02) 201-206.
• 10 Broström EB, Thunqvist P, Adenfelt G. et al. Obstructive lung disease in children with mild to severe BPD. Respir Med 2010; 104 (03) 362-370.
• 11 Chan KN, Silverman M. Increased airway responsiveness in children of low birth weight at school age: effect of topical corticosteroids. Arch Dis Child 1993; 69 (01) 120-124.
• 12 Chess PR, D’Angio CT, Pryhuber GS, Maniscalco WM. Pathogenesis of bronchopulmonary dysplasia. Semin Perinatol 2006; 30 (04) 171-178.
• 13 Doyle LW. Respiratory function at age 8-9 years in extremely low birthweight/very preterm children born in Victoria in 1991-1992. Pediatr Pulmonol 2006; 41 (06) 570-576.
• 14 Doyle LW, Faber B, Callanan C. et al. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics 2006; 118 (01) 108-113.
• 15 Farstad T, Brockmeier F, Bratlid D. Cardiopulmonary function in premature infants with bronchopulmonary dysplasia - a 2-year follow up. Eur J Pediatr 1995; 154 (10) 853-858.
• 16 Filippone M, Sartor M, Zacchello F, Baraldi E. Flow limitation in infants with bronchopulmonary dysplasia and respiratory function at school age. Lancet 2003; 361 9359 753-754.
• 17 Eber E, Zach MS. Long term sequelae of bronchopulmonary dysplasia (chronic lung disease of infancy). Thorax 2001; 56 (04) 317-323.
• 18 Furman L, Baley J, Borawski-Clark E. et al. Hospitalization as a measure of morbidity among very low birth weight infants with chronic lung disease. J Pediatr 1996; 128 (04) 447-452.
• 19 Greenough A, Alexander J, Burgess S. et al. Preschool healthcare utilisation related to home oxygen status. Arch Dis Child Fetal Neonatal Ed 2006; 91 (05) F337-341.
• 20 Greenough A, Broughton S. Chronic manifestations of respiratory syncytial virus infection in premature infants. Pediatr Infect Dis J 2005; 24 (Suppl. 11) S184-187 discussion S187-188.
• 21 Gross SJ, Iannuzzi DM, Kveselis DA, Anbar RD. Effect of preterm birth on pulmonary function at school age: a prospective controlled study. J Pediatr 1998; 133 (02) 188-192.
• 22 Hakulinen AL, Heinonen K, Lansimies E, Kiekara O. Pulmonary function and respiratory morbidity in school-age children born prematurely and ventilated for neonatal respiratory insufficiency. Pediatr Pulmonol 1990; 8 (04) 226-232.
• 23 Hakulinen AL, Jarvenpaa AL, Turpeinen M, Sovijarvi A. Diffusing capacity of the lung in school-aged children born very preterm, with and without bronchopulmonary dysplasia. Pediatr Pulmonol 1996; 21 (06) 353-360.
• 24 Halvorsen T, Skadberg BT, Eide GE. et al. Better care of immature infants; has it influenced long-term pulmonary outcome?. Acta Paediatr 2006; 95 (05) 547-554.
• 25 Hofhuis W, Huysman MW, van der Wiel EC. et al. Worsening of V’maxFRC in infants with chronic lung disease in the first year of life: a more favorable outcome after high-frequency oscillation ventilation. Am J Respir Crit Care Med 2002; 166 (Suppl. 12) Pt 1 1539-1543.
• 26 Jacob SV, Coates AL, Lands LC. et al. Long-term pulmonary sequelae of severe bronchopulmonary dysplasia. J Pediatr 1998; 133 (02) 193-200.
• 27 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729.
• 28 Kilbride HW, Gelatt MC, Sabath RJ. Pulmonary function and exercise capacity for ELBW survivors in preadolescence: effect of neonatal chronic lung disease. J Pediatr 2003; 143 (04) 488-493.
• 29 Kinsella JP, Greenough A, Abman SH. Bronchopulmonary dysplasia. Lancet 2006; 367 9520 1421-1431.
• 30 Kitchen WH, Olinsky A, Doyle LW. et al. Respiratory health and lung function in 8-year-old children of very low birth weight: a cohort study. Pediatrics 1992; 89 (Suppl. 06) Pt 2 1151-1158.
• 31 Korhonen P, Laitinen J, Hyodynmaa E, Tammela O. Respiratory outcome in school-aged, very-low-birth-weight children in the surfactant era. Acta Paediatr 2004; 93 (03) 316-321.
• 32 Koumbourlis AC, Motoyama EK, Mutich RL. et al. Longitudinal follow-up of lung function from childhood to adolescence in prematurely born patients with neonatal chronic lung disease. Pediatr Pulmonol 1996; 21 (01) 28-34.
• 33 Kulasekaran K, Gray PH, Masters B. Chronic lung disease of prematurity and respiratory outcome at eight years of age. J Paediatr Child Health 2007; 43 1-2 44-48.
• 34 Lamarche-Vadel A, Blondel B, Truffer P. et al. Re-hospitalization in infants younger than 29 weeks’ gestation in the EPIPAGE cohort. Acta Paediatr 2004; 93 (10) 1340-1345.
• 35 Lemons JA, Bauer CR, Oh W. et al. Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996. NICHD Neonatal Research Network. Pediatrics 2001; 107 (01) E1.
• 36 Mieskonen ST, Malmberg LP, Kari MA. et al. Exhaled nitric oxide at school age in prematurely born infants with neonatal chronic lung disease. Pediatr Pulmonol 2002; 33 (05) 347-355.
• 37 Narang I, Baraldi E, Silverman M, Bush A. Airway function measurements and the long-term follow-up of survivors of preterm birth with and without chronic lung disease. Pediatr Pulmonol 2006; 41 (06) 497-508.
• 38 Northway Jr. WH. Bronchopulmonary dysplasia: then and now. Arch Dis Child 1990; 65 (10) Spec No 1076-1081.
• 39 Northway Jr WH, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med 1967; 276 (07) 357-368.
• 40 Palta M, Gabbert D, Weinstein MR, Peters ME. Multivariate assessment of traditional risk factors for chronic lung disease in very low birth weight neonates. The Newborn Lung Project. J Pediatr 1991; 119 (02) 285-292.
• 41 Palta M, Sadek-Badawi M, Sheehy M. et al. Respiratory symptoms at age 8 years in a cohort of very low birth weight children. Am J Epidemiol 2001; 154 (06) 521-529.
• 42 Pantalitschka T, Poets CF. Inhaled drugs for the prevention and treatment of bronchopulmonary dysplasia. Pediatr Pulmonol 2006; 41 (08) 703-708.
• 43 Pelkonen AS, Hakulinen AL, Turpeinen M. Bronchial lability and responsiveness in school children born very preterm. Am J Respir Crit Care Med 1997; 156 (04) Pt 1 1178-1184.
• 44 Pelkonen AS, Hakulinen AL, Hallman M, Turpeinen M. Effect of inhaled budesonide therapy on lung function in schoolchildren born preterm. Respir Med 2001; 95 (07) 565-570.
• 45 Robin B, Kim YJ, Huth J. et al. Pulmonary function in bronchopulmonary dysplasia. Pediatr Pulmonol 2004; 37 (03) 236-242.
• 46 Smith VC, Zupancic JA, McCormick MC. et al. Re-hospitalization in the first year of life among infants with bronchopulmonary dysplasia. J Pediatr 2004; 144 (06) 799-803.
• 47 Vrijlandt EJ, Gerritsen J, Boezen HM, Duiverman EJ. Gender differences in respiratory symptoms in 19-year-old adults born preterm. Respir Res 2005; 6: 117.
• 48 Wauer RR. Epidemiologie neonataler, respiratorischer Erkrankungen. Wauer RR. Surfactant-therapie. 3. überarb. u. erw. Aufl. Stuttgart: Thieme; 2004: 90-98.
• 49 Welsh L, Kirkby J, Lum S. et al. The EPICure study: maximal exercise and physical activity in school children born extremely preterm. Thorax 2010; 65 (02) 165-172.