Validation of the National Institutes of Health Consensus Definition of Bronchopulmonary Dysplasia

@article{Ehrenkranz2005ValidationOT,
  title={Validation of the National Institutes of Health Consensus Definition of Bronchopulmonary Dysplasia},
  author={Richard A. Ehrenkranz and Michele C. Walsh and Betty R. Vohr and Alan H. Jobe and Linda L. Wright and Avroy A. Fanaroff and Lisa A. Wrage and Kenneth W. Poole},
  journal={Pediatrics},
  year={2005},
  volume={116},
  pages={1353 - 1360}
}
Objective. A number of definitions of bronchopulmonary dysplasia (BPD), or chronic lung disease, have been used. A June 2000 National Institute of Child Health and Human Development/National Heart, Lung, and Blood Institute Workshop proposed a severity-based definition of BPD for infants <32 weeks’ gestational age (GA). Mild BPD was defined as a need for supplemental oxygen (O2) for ≥28 days but not at 36 weeks’ postmenstrual age (PMA) or discharge, moderate BPD as O2 for ≥28 days plus… Expand
The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach
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The definition of bronchopulmonary dysplasia that best predicted early childhood morbidity categorized disease severity according to the mode of respiratory support administered at 36 weeks’ postmenstrual age, regardless of supplemental oxygen use. Expand
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validation studies of BPD with respect to outcomes defining respiratory morbidity at 1–2 years corrected age have predominantly been based on binary clinical definitions of B PD. Expand
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The NICHD 2018 definition of BPD has better predictive ability on mortality and pulmonary morbidities than the NIH 2001 definition, and adequately predicted mortality and morbidities of preterm infants. Expand
Need for an International Consensus on the Definition of Bronchopulmonary Dysplasia
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  • Medicine
  • American Journal of Respiratory and Critical Care Medicine
  • 2019
TLDR
The proposed definition of BPD, though marginally better at predicting outcomes, will not consistently meet the challenge of defining BPD and will not be appropriate for research or benchmarking focused on pulmonary outcomes. Expand
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Using a physiologic definition based on an oxygen reduction challenge at 36 weeks PMA led to a 10% decrease in the incidence of Bronchopulmonary dysplasia. Expand
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It is found that incorporating the total number of days requiring O2 (without restricting at 36 weeks PMA) improved the prediction of respiratory outcomes according to BPD severity and a new severity category with prolonged exposure to supplemental O2 that has the highest risk of respiratory hospitalizations after discharge is defined. Expand
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TLDR
The severity-based classification of bronchopulmonary dysplasia clarifies the relationship between BPD and developmental sequelae and was associated with poorer outcomes. Expand
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TLDR
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TLDR
Compared with the 2018 NICHD definition of BPD, the 2001 NICHD consensus definition may result in more cases of false-positive or unclassified severity, however, it may be a better indicator of severe respiratory morbidities or death during the first 18–24 months. Expand
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Whether a diagnosis of BPD or respiratory morbidity (RM1 or RM2) at 12 months corrected age better predicted subsequent RM in extremely low gestational age infants (23-28 weeks of gestation) is determined. Expand
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References

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TLDR
The new system for grading the severity of BPD offers a better description of underlying pulmonary disease and correlates with the infant's maturity, growth and overall severity of illness. Expand
Impact of a Physiologic Definition on Bronchopulmonary Dysplasia Rates
TLDR
The physiologic definition of BPD facilitates the measurement of B PD as an outcome in clinical trials and the comparison between and within centers over time, and reduced the variation among centers. Expand
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During a period when 21% of neonates were exposed to antenatal steroids, 24% received surfactant and 9% received postnatal corticosteroids, radiographic evidence was more predictive of long-term respiratory outcome than other commonly used criteria. Expand
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Poor pulmonary outcome and poor neurosensory outcome are common late adverse outcomes in this population of infants and BPD as defined by duration of oxygen therapy is a less accurate surrogate currently than in previous eras. Expand
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TLDR
Children with BPD-2 are similar to the other groups at 18 months in growth, general health, and neurologic outcome but differ in having a higher number of days of rehospitalizations for respiratory causes, more hernia repairs, and more developmental delays. Expand
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TLDR
The ventilatory impairments in BPD were of the same nature as in healthy preterm infants when compared with term infants, but their magnitude was related to the clinical severity of the BPD. Expand
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TLDR
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TLDR
Among premature infants, BPD substantially increases the risk of rehospitalization during the first year of life and neither demographic nor physiologic factors predicted re hospitalization among the infants with BPD. Expand
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