Conclusions

The obstructive phenotype was the most prevalent and was associated with greater birth weight. Although seen in only 9% of patients with sBPD, the purely restrictive phenotype and its diagnosis may be important from a therapeutic prospective because these patients can likely be weaned relatively quickly from positive pressure, and none of the purely restrictive patients were discharged from the hospital on mechanical ventilation. All 3 phenotypes revealed a subset of patients who responded to bronchodilator therapy, and responders had a lower FEV_0.5 at baseline than did nonresponders. Our findings reveal that sBPD as it is currently defined includes different phenotypes that may require different therapeutic approaches. In patients with sBPD who are not clinically improving, we would suggest that iPFT may be considered to determine their phenotypes to help guide ongoing therapies. Given that most NICUs do not have access to a pulmonary function testing laboratory, in the long-term, it would be helpful to develop easier bedside testing to differentiate these phenotypes, and we suggest that this should be a focused area of future research. Finally, the iPFT for phenotypes could also be used to direct future therapeutic trials in patients with sBPD.

Strategies

N = 56, 10, and 44, respectively, for all data except Crs, for which N = 48, 5, and 32, respectively. Leggi il resto di questo articolo »