Growth of lung parenchyma in infants and toddlers with chronic lung disease of infancy

Juan E. Balinotti, Valentina C. Chakr, Christina Tiller, Risa Kimmel, Cathy Coates, Jeffrey Kisling, Zhangsheng Yu, James Nguyen, Robert S. Tepper

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

Rationale: The clinical pathology describing infants with chronic lung disease of infancy (CLDI) has been limited and obtained primarily from infants with severe lung disease, who either died or required lung biopsy. As lung tissue from clinically stable outpatients is not available, physiological measurements offer the potential to increase our understanding of the pulmonary pathophysiology of this disease. Objectives: We hypothesized that if premature birth and the development of CLDIresult in disruption of alveolardevelopment, then infants and toddlers with CLDI would have a lower pulmonary diffusing capacity relative to their alveolar volume compared with full-term control subjects. Methods: We measured pulmonary diffusing capacity and alveolar volume, using a single breath-hold maneuver at elevated lung volume. Subjects with chronic lung disease of infancy (23-29 wk of gestation; n = 39) were compared with full-term control subjects (n = 61) at corrected ages of 11.6 (4.8-17.0) and 13.6 (3.2-33) months, respectively. Measurements and Main Results: Alveolar volume and pulmonary diffusing capacity increased with increasing body length for both groups. After adjusting for body length, subjects with CLDI had significantly lower pulmonary diffusing capacity (2.88 vs. 3.23 ml/min/mm Hg; P = 0.0004), but no difference in volume (545 vs. 555 ml; P = 0.58). Conclusions: Infants and toddlers with CLDI have decreased pulmonary diffusing capacity, but normal alveolar volume. These physiological findings are consistent with the morphometric data obtained from subjects with severe lung disease, which suggests an impairment of alveolar development after very premature birth.

Original languageEnglish (US)
Pages (from-to)1093-1097
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Volume181
Issue number10
DOIs
StatePublished - May 15 2010

Keywords

  • Alveolar volume
  • Bronchopulmonary dysplasia
  • Lung parenchyma
  • Pulmonary diffusing capacity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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