Cardiovascular Risk Factors and Excess Adiposity Among Overweight Children and Adolescents: The Bogalusa Heart Study

Rationale: The 1994 American European Consensus Committee definitions of acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) have not been applied systematically in the pediatric population. Objectives: The purpose of this study was to evaluate prospectively the epidemiology and clinical risk factors associated with death and prolonged mechanical ventilation in all pediatric patients admitted to two large, pediatric intensive care units with ALI/ARDS using Consensus criteria. Methods: All pediatric patients meeting Consensus Committee definitions for ALI were prospectively identified and included in a relational database. Measurements and Main Results: There were 328 admissions for ALI/ARDS with a mortality of 22%. Multivariate logistic regression analyses revealed (1) the initial severity of oxygenation defect, as measured by the PaO2/FIO2 ratio; (2) the presence of nonpulmonary and non–central nervous system (CNS) organ dysfunction; and (3) the presence of CNS dysfunction were ind...

https://www.atsjournals.org/doi/pdf/10.1164/rccm.200404-544OC

Pediatric acute lung injury: prospective evaluation of risk factors associated with mortality.

Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease associated with premature birth that primarily affects infants born at less than 28 weeks’ gestational age. BPD is the most common serious complication experienced by premature infants, with more than 8,000 newly diagnosed infants annually in the United States alone. In light of the increasing numbers of preterm survivors with BPD, improving the current state of knowledge of long-term respiratory morbidity for infants with BPD is a priority. We undertook a comprehensive review of the published literature to analyze and consolidate current knowledge of the effects of BPD that are recognized at specific stages of life, including infancy, childhood, and adulthood. In this review, we discuss both the short-term and long-term respiratory outcomes of individuals diagnosed as infants with the disease and highlight the gaps in knowledge needed to improve early and lifelong management of these patients.

/pdf/understanding-the-short-and-long-term-respiratory-outcomes-4l1x412n36.pdf

Understanding the Short- and Long-Term Respiratory Outcomes of Prematurity and Bronchopulmonary Dysplasia.

Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study.

Bronchopulmonary dysplasia (BPD) is the most common form of chronic lung disease in infancy. The clinical, radiological, and pathological features of BPD were first described a little more than three decades ago.1 The disease was then seen in large preterm infants with severe respiratory distress syndrome who had been treated with high inspired oxygen concentrations and prolonged mechanical ventilation with high positive airway pressures resulting in inflammation, fibrosis, and smooth muscle hypertrophy in the airways.2 Despite advances in the prevention and management of respiratory distress syndrome (including the widespread use of antenatal steroids and surfactant treatment), neonatal chronic lung disease is still one of the major complications in mechanically ventilated premature infants. Acceptance of modest hypercapnia with less aggressive application of positive pressure ventilation and reduction of the use of high oxygen concentrations led to a decrease in the incidence of BPD in newborn infants with a birth weight above 1500 g. However, with increased survival of extremely premature infants (24–26 weeks gestation, birth weight 1250 g.3 Apart from differences in patient populations and management, the reported variation in the incidence of BPD might also be due to the use of different criteria to define it.1 11 12 

“Classic” BPD, as described by Northway and colleagues, is a severe form of chronic lung disease that has become less common and has been replaced by less severe forms which are observed in very small premature infants who survive after prolonged mechanical ventilation.8 …

https://thorax.bmj.com/content/thoraxjnl/56/4/317.full.pdf

Long term sequelae of bronchopulmonary dysplasia (chronic lung disease of infancy)

The impact of very low birthweight (<1500 g) and bronchopulmonary dysplasia (BPD) on respiratory morbidity, on need of medical resources and rehabilitation at 2-8 y of age, and on the everyday life of the child's family was evaluated by means of a questionnaire addressed to parents of 143 very low birthweight children, 36 of whom had had BPD at 28 d postnatal age, and 131 term controls. In the preceding year, respiratory symptoms provoked by exercise, use of inhaled medications, regular follow-up visits and hospitalizations, need for physiotherapy, occupational therapy, technical aids and financial support from society had been more common in the very low birthweight groups compared to children born at term. Children with BPD suffered respiratory infections and needed antibiotic courses more frequently than term controls. Repeated antibiotic courses, physiotherapy and occupational therapy were more common among very low birthweight children with BPD than among those without. Concern for the child and the impact of the child's health on his or her everyday life and the parents' work and education were more often reported in target families than in term controls. Compared to term families, more parents in the BPD group felt that the child's health affected the pastimes of other family members. To the families concerned, very low birthweight and BPD constitute a significant burden far beyond the neonatal period. Validated scales for the assessment of their quality of life are needed to develop supportive measures and to evaluate the effects of such interventions.

Very low birthweight, bronchopulmonary dysplasia and health in early childhood.

Frequency and risk factors in bronchopulmonary dysplasia in a cohort of very low birth weight infants

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Very low birthweight, bronchopulmonary dysplasia and health in early childhood.

Frequency and risk factors in bronchopulmonary dysplasia in a cohort of very low birth weight infants