Öz
AMAÇ: Bronkopulmoner displazi (BPD), günümüzde prematüre bebekleri etkileyen en önemli solunum sistemi morbiditesi ol-maya devam etmektedir. Bu çalışmanın amacı, Eunice Kennedy Shriver Ulusal Çocuk Sağlığı ve İnsan Gelişimi Enstitüsü’ne (NI-CHD) ait BPD sonuç tahmin aracının 2022 versiyonunun doğru-luğunu değerlendirmektir.GEREÇ VE YÖNTEM: Bu retrospektif kohort çalışmada, doğum ağırlıkları 501 ile 1249 gram arasında ve gebelik haftaları 23 ile 28 hafta arasında olan prematüre bebekler değerlendirilmiştir. 1 Ocak 2021 ile 31 Aralık 2022 tarihleri arasında üçüncü basa-mak bir yenidoğan yoğun bakım ünitesinde doğan ve çalışma kriterlerini karşılayan prematüreler çalışmaya alınmıştır. 2022 BPD tahmin edici aracının BPD şiddeti ve mortalite tahmini ko-nusundaki doğruluğu, hastaların klinik sonuçları temel alınarak değerlendirilmiştir.BULGULAR: Çalışma kriterlerine uygun toplam 118 prematüre bebek dahil edilmiştir. Bebeklerin %56’sı (n=66) kızdı. Doğum ağırlıkları 530 gram ile 1240 gram arasında, gebelik haftaları ise 24 ile 28 hafta arasında değişmekteydi. 2022 BPD tahmin aracı, 1., 3., 7. ve 14. günlerde hastaların mortalite, ciddi BPD gelişi-mi ve BPD’siz sağkalım durumlarını; 28. günde ise ciddi BPD ve BPD’siz sağkalımı öngörmede istatistiksel olarak anlamlı düzey-de başarılı bulunmuştur (p<0,05).SONUÇ: BPD’yi doğru bir şekilde tahmin etmek, BPD ile ilişkili morbidite ve mortaliteyi yönetme ve önleme stratejilerinin ge-liştirilmesi açısından kritik öneme sahiptir. BPD sonuç tahmin aracı gibi bir hesaplayıcının, ciddi BPD, mortalite ve BPD’siz sağ-kalımı öngörebilme yeteneği son derece değerlidir.
Anahtar Kelimeler
Kaynakça
- 1. Northway WH Jr, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967;276(07):357–68.
- 2. Bancalari E, Jain D. Bronchopulmonary Dysplasia: 50 Years after the Original Description. Neonatology. 2019;115(4):384-91.
- 3. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(07):1723–9.
- 4. Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop. J Pediatr. 2018;197:300–8.
- 5. Jensen EA, Dysart K, Gantz MG, et al. The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach. Am J Respir Crit Care Med. 2019;200(6):751-9.
- 6. DeMauro SB. Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia. Pediatr Pulmonol. 2021;56(11):3509-17.
- 7. Cheong JLY, Doyle LW. Long-term effects of postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia: Balancing the risks and benefits. Semin Fetal Neonatal Med. 2019;24(3):197-201.
- 8. Onland W, Debray TP, Laughon MM, et al. Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study. BMC Pediatr. 2013;17(13):207.
- 9. Laughon MM, Langer JC, Bose CL, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med. 2011;183(12):1715-22.
- 10. Greenberg RG, McDonald SA, Laughon MM, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed. 2022;21: fetalneonatal-2021-323573.
- 11. Stoll BJ, Hansen NI, Bell EF, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA. 2015;314(10):1039-51.
- 12. Doyle LW, Carse E, Adams AM, et al. Victorian Infant Collaborative Study Group. Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years. N Engl J Med. 2017;377(4):329-37.
- 13. Klinger G, Sirota L, Lusky A, et al. Bronchopulmonary dysplasia in very low birth weight infants is associated with prolonged hospital stay. J Perinatol. 2006;26(10):640-4.
- 14. Homan TD, Nayak RP. Short- and Long-Term Complications of Bronchopulmonary Dysplasia. Respir Care. 2021;66(10):1618-29.
- 15. Verder H, Heiring C, Ramanathan R, et al. Bronchopulmonary dysplasia predicted at birth by artificial intelligence. Acta Paediatr. 2021;110(2):503-9.
- 16. Baker EK, Davis PG. Bronchopulmonary dysplasia outcome estimator in current neonatal practice. Acta Paediatr. 2021;110(1):166-7.
- 17. Cuna A, Liu C, Govindarajan S, et al. Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm. J Pediatr. 2018;197:23-28.e2.
- 18. Srivatsa B, Srivatsa KR, Clark RH. Assessment of validity and utility of a bronchopulmonary dysplasia outcome estimator. Pediatr Pulmonol. 2023;58(3):788-93.
EVALUATION OF THE USE OF BRONCHOPULMONARY DYSPLASIA OUTCOME ESTIMATOR IN THE NEONATAL INTENSIVE CARE UNIT
Öz
OBJECTIVE: Bronchopulmonary dysplasia (BPD) remains the most important respiratory morbidity affecting premature infants to this day. The aim of this study is to evaluate the accuracy of 2022 version of the Eunice Kennedy Shriver National Institute of Child Health and Human Development BPD outcome estimator.
MATERIAL AND METHODS: This retrospective cohort study evaluated premature infants with birth weights ranging from 501 to 1249 grams and gestational ages between 23 and 28 weeks. Premature infants born between January 1, 2021, and December 31, 2022, at a tertiary-level neonatal intensive care unit who met the inclusion criteria, were included in the study. The predictive accuracy of the 2022 BPD Outcome Estimator in determining the severity of BPD and mortality was evaluated based on the patients' clinical outcomes.
RESULTS: A total of 118 premature infants who met the inclusion criteria were included in the study. Fifty-six percent (n=66) of the infants were female. The birth weights of the patients ranged from 530 g to 1240, and the gestational weeks ranged from 24 to 28 weeks. The 2022 BPD Outcome Estimator has been found to be statistically significantly robust in predicting both mortality and severe BPD as well as BPD-free survival on days 1, 3, 7, and 14, and predicting severe BPD and BPD-free survival on day 28 (p<0.05).
CONCLUSIONS: Accurate prediction of BPD is crucial for developing strategies to manage and prevent BPD-related mortality and morbidities. The ability of tools such as the BPD Outcome Estimator to predict severe BPD, mortality, and BPD-free survival is highly valuable in clinical practice.
Anahtar Kelimeler
Etik Beyan
Approval for this study was obtained from the local ethics committee
Kaynakça
- 1. Northway WH Jr, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967;276(07):357–68.
- 2. Bancalari E, Jain D. Bronchopulmonary Dysplasia: 50 Years after the Original Description. Neonatology. 2019;115(4):384-91.
- 3. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(07):1723–9.
- 4. Higgins RD, Jobe AH, Koso-Thomas M, et al. Bronchopulmonary dysplasia: executive summary of a workshop. J Pediatr. 2018;197:300–8.
- 5. Jensen EA, Dysart K, Gantz MG, et al. The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach. Am J Respir Crit Care Med. 2019;200(6):751-9.
- 6. DeMauro SB. Neurodevelopmental outcomes of infants with bronchopulmonary dysplasia. Pediatr Pulmonol. 2021;56(11):3509-17.
- 7. Cheong JLY, Doyle LW. Long-term effects of postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia: Balancing the risks and benefits. Semin Fetal Neonatal Med. 2019;24(3):197-201.
- 8. Onland W, Debray TP, Laughon MM, et al. Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study. BMC Pediatr. 2013;17(13):207.
- 9. Laughon MM, Langer JC, Bose CL, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants. Am J Respir Crit Care Med. 2011;183(12):1715-22.
- 10. Greenberg RG, McDonald SA, Laughon MM, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed. 2022;21: fetalneonatal-2021-323573.
- 11. Stoll BJ, Hansen NI, Bell EF, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA. 2015;314(10):1039-51.
- 12. Doyle LW, Carse E, Adams AM, et al. Victorian Infant Collaborative Study Group. Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years. N Engl J Med. 2017;377(4):329-37.
- 13. Klinger G, Sirota L, Lusky A, et al. Bronchopulmonary dysplasia in very low birth weight infants is associated with prolonged hospital stay. J Perinatol. 2006;26(10):640-4.
- 14. Homan TD, Nayak RP. Short- and Long-Term Complications of Bronchopulmonary Dysplasia. Respir Care. 2021;66(10):1618-29.
- 15. Verder H, Heiring C, Ramanathan R, et al. Bronchopulmonary dysplasia predicted at birth by artificial intelligence. Acta Paediatr. 2021;110(2):503-9.
- 16. Baker EK, Davis PG. Bronchopulmonary dysplasia outcome estimator in current neonatal practice. Acta Paediatr. 2021;110(1):166-7.
- 17. Cuna A, Liu C, Govindarajan S, et al. Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm. J Pediatr. 2018;197:23-28.e2.
- 18. Srivatsa B, Srivatsa KR, Clark RH. Assessment of validity and utility of a bronchopulmonary dysplasia outcome estimator. Pediatr Pulmonol. 2023;58(3):788-93.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Yenidoğan |
| Bölüm | Makaleler-Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Temmuz 2025 |
| Gönderilme Tarihi | 3 Haziran 2025 |
| Kabul Tarihi | 23 Haziran 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 26 Sayı: 3 |
Kaynak Göster
