Acute and Chronic Lung Disease of the Neonate: Open Challenges and Novel Insights

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Pulmonary and Sleep Medicine".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 5707

Special Issue Editor


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Guest Editor
Neonatal and Paediatric Intensive Care Unit, Maurizio Bufalini Hospital, AUSL Romagna, Cesena, Italy
Interests: bronchopulmonary dysplasia; neonates; lung ultrasound; mechanical ventilation
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Special Issue Information

Dear Colleagues,

Respiratory disorders are the leading cause of admission to neonatal intensive care units, carrying high rates of mortality and morbidity. The definition and characterization of neonatal lung disorders are still a matter of debate. Preclinical and clinical research pertaining to novel ventilation strategies that may decrease the burden of superimposed ventilator-induced lung injury is a continuous field of improvement in neonatology. The point of care evaluation of the respiratory and cardiovascular system is constantly growing and constitutes a potential game-changer when dealing with neonatal lung diseases.

The purpose of this Special Issue is to collect contributions of clinical practice and research on neonatal lung diseases. This volume intends to provide novel insights into neonatal lung diseases, including prevention, diagnosis, monitoring, ventilator strategies and ECMO, novel treatments, supportive strategies and long-term outcomes. In addition to reviews, all types of research papers, from laboratory studies to pro- and retrospective clinical trials, are most welcome. Outstanding case reports with clear added scientific value are also acceptable.

Considering the success and popularity of the Special Issue "Acute and Chronic Lung Disease of the Newborn: Open Challenges and Novel Insights" previously published in Children (https://www.mdpi.com/journal/children/special_issues/acute_chronic_lung_disease_prematurity), we now release a second Special Issue aiming to gather original research papers and review articles related to acute and chronic neonatal lung disease. We look forward to potentially collaborating with you and hope to hear back from you soon.

Dr. Maria Pierro
Guest Editor

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Keywords

  • acute lung disease of prematurity
  • neonatal acute respiratory distress syndrome
  • transient tachypnea of the newborn
  • chronic lung disease of prematurity
  • bronchopulmonary dysplasia
  • ventilator-induced lung injury

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Published Papers (3 papers)

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Research

10 pages, 1208 KiB  
Article
Predictive and Diagnostic Values of Systemic Inflammatory Indices in Bronchopulmonary Dysplasia
by Linxia Cao, Xiangye Liu, Tingting Sun, Yuan Zhang, Tianping Bao, Huaiping Cheng and Zhaofang Tian
Children 2024, 11(1), 24; https://doi.org/10.3390/children11010024 - 25 Dec 2023
Cited by 3 | Viewed by 1737
Abstract
Background: Bronchopulmonary dysplasia (BPD) is the most common respiratory complication in preterm infants, and there is a lag in the diagnosis of BPD. Inflammation is a vital pathogenic factor for BPD; we aim to evaluate the predictive and diagnostic values of systemic inflammatory [...] Read more.
Background: Bronchopulmonary dysplasia (BPD) is the most common respiratory complication in preterm infants, and there is a lag in the diagnosis of BPD. Inflammation is a vital pathogenic factor for BPD; we aim to evaluate the predictive and diagnostic values of systemic inflammatory indices in BPD. Methods: Between 1 January 2019 and 31 May 2023, the clinical data of 122 premature infants with a gestational age of <32 weeks in the Department of Neonatology, the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, were retrospectively collected and classified into non-BPD (n = 72) and BPD (n = 50) groups based on the National Institute of Child Health and Human Development 2018 criteria. To compare the general characteristics of each group, we identified the independent risk variables for BPD using multivariate logistic regression analysis, compared the systemic inflammatory indices at birth, 72 h, 1 week, 2 weeks, and 36 weeks postmenstrual age (PMA), and constructed the receiver operating characteristic curves of neutrophil-to-lymphocyte ratio (NLR) diagnosis of BPD at different time points. Results: ① The independent risk factors for BPD in preterm infants were birth weight, small for gestational age, and days of oxygen therapy (all p < 0.05). ② At 72 h and 1 week after birth, the serum NLR of the BPD group was higher than for the non-BPD group (p < 0.05). Furthermore, the neutrophil count (N), NLR, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index (SIRI), and pan-immune-inflammation value of infants with BPD were higher than the non-BPD group at 3 weeks after birth (p < 0.05). Moreover, at 36 weeks of PMA, the serum N, NLR, MLR, and SIRI of BPD infants were higher than those of non-BPD infants (p < 0.05). ③ The NLR of infants with and without BPD gradually increased after birth, reaching a peak at 72 h and 1 week, respectively. At 3 weeks postnatal, the NLR had the highest predictive power for BPD, with an area under the curve (AUC) of 0.717 (p < 0.001); the sensitivity was 56% and specificity was 86.1%. In addition, the NLR at 36 weeks of PMA exhibited some diagnostic value for BPD. The AUC was 0.693 (p < 0.001), the sensitivity was 54%, and specificity was 83.3%. Conclusions: At 3 weeks after birth and 36 weeks of PMA, some systemic inflammation indices (like N, NLR, SIRI) of preterm infants with BPD have specific predictive and diagnostic values; these indices may help the management of high-risk preterm infants with BPD. Full article
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10 pages, 435 KiB  
Article
Early Respiratory Physiotherapy versus an Individualized Postural Care Program for Reducing Mechanical Ventilation in Preterm Infants: A Randomised Controlled Trial
by Milena Tana, Anthea Bottoni, Francesco Cota, Patrizia Papacci, Alessia Di Polito, Arianna Del Vecchio, Anna Laura Vento, Benedetta Campagnola, Sefora Celona, Laura Cricenti, Ilaria Bastoni, Chiara Tirone, Claudia Aurilia, Alessandra Lio, Angela Paladini, Stefano Nobile, Alessandro Perri, Annamaria Sbordone, Alice Esposito, Simona Fattore, Paola Emilia Ferrara, Gianpaolo Ronconi and Giovanni Ventoadd Show full author list remove Hide full author list
Children 2023, 10(11), 1761; https://doi.org/10.3390/children10111761 - 30 Oct 2023
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Abstract
Background: Tactile stimulation manoeuvres stimulate spontaneous breathing in preterm newborns. The aim of this study is to evaluate the effect of early respiratory physiotherapy on the need for mechanical ventilation during the first week of life in preterm infants with respiratory failure. Methods: [...] Read more.
Background: Tactile stimulation manoeuvres stimulate spontaneous breathing in preterm newborns. The aim of this study is to evaluate the effect of early respiratory physiotherapy on the need for mechanical ventilation during the first week of life in preterm infants with respiratory failure. Methods: This is a monocentric, randomised controlled trial. Preterm infants (gestational age ≤ 30 weeks) not intubated in the delivery room and requiring non-invasive respiratory support at birth were eligible for the study. The intervention group received early respiratory physiotherapy, while the control group received only a daily physiotherapy program (i.e., modifying the infant’s posture in accordance with the patient’s needs). Results: between October 2019 and March 2021, 133 preterm infants were studied, 68 infants in the study group and 65 in routine care. The study group showed a reduction in the need for mechanical ventilation (not statistically significant) and a statistically significant reduction in hemodynamically significant patent ductus arteriosus with respect to the control group (19/68 (28%) vs. 35/65 (54%), respectively, p = 0.03). Conclusions: early respiratory physiotherapy in preterm infants requiring non-invasive respiratory support at birth is safe and has proven to be protective against haemodynamically significant PDA. Full article
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7 pages, 1204 KiB  
Article
The Pandemic Allocation of Ventilators Model Penalizes Infants with Bronchopulmonary Dysplasia
by Anupama Sundaram, Jonathan M. Fanaroff, Deanne Wilson-Costello, Melissa Alberts, Naini Shiswawala, Noam Stern and Rita M. Ryan
Children 2023, 10(8), 1404; https://doi.org/10.3390/children10081404 - 17 Aug 2023
Viewed by 1344
Abstract
During the COVID-19 pandemic, institutions developed ventilator allocation models. In one proposed model, neonates compete with adults for ventilators using a scoring system. Points are given for conditions that increase one- and five-year (y) mortality. For example, comparable points were added for adult [...] Read more.
During the COVID-19 pandemic, institutions developed ventilator allocation models. In one proposed model, neonates compete with adults for ventilators using a scoring system. Points are given for conditions that increase one- and five-year (y) mortality. For example, comparable points were added for adult conditions with mortality of 71.3% and for neonates with moderate or severe bronchopulmonary dysplasia (mod/sBPD). We hypothesized that this model overestimates mortality in neonates with BPD and would penalize these infants unfairly. There was little information available on 1 y and 5 y mortality risk for mod/sBPD. To evaluate this allocation protocol, a retrospective chart review was performed on infants born ≥22 weeks and weighing <1500 g admitted to Rainbow Babies and Children’s Hospital in 2015 to identify babies with BPD. The main outcomes were 1 and 5 y mortality. In 2015, 28 infants were diagnosed with mod/s BPD based on NIH 2001 definition; 4 infants had modBPD and 24 had sBPD. All infants (100%) with modBPD survived to 5 y; 2 infants with sBPD died by 1 y (8%) and 22 survived (92%) to 1 y; 3 died (12.5%) by 5 y; and at least 13 survived (54%) to 5 y. Infants with mod/s BPD had lower-than-predicted 1 and 5 y mortality, suggesting the points assigned in the model are too high for these conditions. We believe this model would unfairly penalize these babies. Full article
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