Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Department of Pediatrics, Division of Critical Care Medicine, McGovern Medical School at UTHealth, Houston, Texas, USA.
Pediatr Pulmonol. 2021 Nov;56(11):3527-3532. doi: 10.1002/ppul.25434. Epub 2021 Apr 30.
Despite marked improvements in the survival of extremely low birth weight preterm infants, bronchopulmonary dysplasia (BPD) remains a prevalent morbidity. BPD has evolved pathologically and epidemiologically but the definition has failed to keep up. The majority of the definitions of BPD still use the respiratory support provided to the infants at a single timepoint. The lack of a uniform definition of BPD presently reflects the changing BPD pathogenesis and phenotype and limits defining the epidemiology. To address the epidemiology of BPD, the definition should be clarified; even the newer definitions have not been validated entirely. The definition needs to be meaningful clinically and be predictive of long-term respiratory outcomes. We believe the definition should have a composite assessment like a score (quantitative measurement) and include the different phenotypes (qualitative measurements) so that optimally they can be applied to the different phases of BPD and at different timepoints. Furthermore, the definitions need to be easy to measure and assess so that generalizability is enhanced.
尽管极低出生体重早产儿的存活率有了显著提高,但支气管肺发育不良(BPD)仍然是一种普遍的发病率。BPD 在病理和流行病学上都有了发展,但定义却没有跟上。大多数 BPD 的定义仍然使用单一时间点为婴儿提供的呼吸支持来定义。目前,BPD 缺乏统一的定义反映了 BPD 发病机制和表型的变化,并限制了对其流行病学的定义。为了解决 BPD 的流行病学问题,需要澄清定义;即使是较新的定义也没有完全得到验证。该定义在临床上必须具有意义,并能预测长期呼吸结局。我们认为,该定义应该具有像评分(定量测量)这样的综合评估,并包括不同的表型(定性测量),以便它们能够在 BPD 的不同阶段和不同时间点最佳地应用。此外,该定义需要易于测量和评估,以提高其可推广性。