Lung biopsy in infants with severe bronchopulmonary dysplasia

被引:0
|
作者
Callaway, Danielle A. [1 ]
Wang, Yifei [2 ]
Lingappan, Krithika [1 ]
Pogoriler, Jennifer E. [3 ]
Laje, Pablo [4 ]
Nilan, Kathleen [1 ]
Kirpalani, Haresh [5 ,6 ]
Zhang, Huayan [1 ,7 ,8 ,9 ]
机构
[1] Childrens Hosp Philadelphia, Dept Pediat, Div Neonatol, Philadelphia, PA USA
[2] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Neonatol, Guangzhou, Peoples R China
[3] Childrens Hosp Philadelphia, Dept Pathol, Philadelphia, PA USA
[4] Childrens Hosp Philadelphia, Div Gen Thorac & Fetal Surg, Philadelphia, PA USA
[5] McMaster Univ, Pediat, Hamilton, ON, Canada
[6] Univ Penn, Philadelphia, PA USA
[7] Guangzhou Women & Childrens Med Ctr, Div Neonatol, Guangzhou, Guangdong, Peoples R China
[8] Guangzhou Women & Childrens Med Ctr, Ctr Newborn Care, Guangzhou, Guangdong, Peoples R China
[9] Childrens Hosp Philadelphia, 3615 Civ Ctr Blvd, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
bronchopulmonary dysplasia; childhood interstitial lung disease; lung biopsy; PRETERM INFANTS; DISEASE; CHILDREN; CLASSIFICATION; MUTATIONS;
D O I
10.1002/ppul.26433
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
IntroductionLung biopsy is infrequently performed in the population of infants with severe bronchopulmonary dysplasia (BPD). Yet, its presentation may overlap with other infant diffuse lung diseases, including those within the spectrum of childhood interstitial lung diseases (chILD). Lung biopsy might differentiate between these entities or identify those with an extremely poor prognosis. Both might alter the clinical management of some infants diagnosed with BPD. MethodsIn this tertiary referral center, we drew on a retrospective cohort of 308 preterm infants with severe BPD. Of these, nine underwent lung biopsy between 2012 and 2017. We aimed to assess the indication for lung biopsy, the prior clinical history, safety of the procedure, and describe the biopsy findings. Finally, we considered management decisions in relation to the biopsy results in these patients. ResultsAll nine infants undergoing biopsy survived the procedure. The mean gestational age and birth weight of the nine patients were 30 +/- 3 (range 27-34) weeks and 1421 +/- 571 (range 611-2140) grams. All infants received serial echocardiograms to assess pulmonary hypertension, genetic testing, and computed tomography angiography (CTA) before biopsy. In all nine patients moderate to severe alveolar simplification was present and eight had some degree of pulmonary interstitial glycogenosis (PIG) ranging from focal to diffuse. Following biopsy, two infants with PIG received high dose systemic steroids and two separate infants had care redirected. ConclusionIn our cohort, lung biopsy was safe and well tolerated. Findings from lung biopsy may aid decision making in selected patients as a part of a step-wise diagnostic algorithm.
引用
收藏
页码:2068 / 2075
页数:8
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