Methods of prognosis of the bronchopulmonary dysplasia clinical course in children of one year old
DOI:
https://doi.org/10.15587/2313-8416.2015.57089Keywords:
bronchopulmonary dysplasia, prognostication of clinical course, groups of catamnestic observationAbstract
Aim: to estimate an effectiveness of the different sceneries of bronchopulmonary dysplasia (BPD) prognostication in one year old prematurely born children with perinatal pathology.
Materials and methods. There was carried out an analysis of results of observation on the dynamic of age-specific clinical course of BPD in 105 children from the newborn period till 3 years old. An age-specific dynamics was estimated at three month and at 1 year old. Using methods of mathematical statistics there was studied an influence of postnatal factors on determination of the clinical course and clinical outcome of BPD at the age of 1 year.
Results and discussion. According to the results of observation for the study of the character of postnatal factors influence of BPD dynamic at the age of 1 year there were formed alternative groups: with moderate or significant (including recovery) improvement and insignificant improvement. There were selected the most significant criteria of recovery that were registered at an absence of recovery at BPD. The complex analysis of prognostic importance of the several types of factors demonstrated: the first cluster is represented by BPD clinic at 6 month (Ī=3,62) and BPD severity (Ī=3,52); the second cluster included sex of patient (Ī=1,64), the duration of intensive care (Ī=1,50) and the treatment of surfactant (Ī=1,12); the third cluster is represented by gestational maturity (Ī=0,98) and the state of newborn on Apgar scale (І=0,93) and concomitant pathology is the last one in the rank order (Ī=0,48). In the result of the study there were elaborated the prognostic sceneries that determine the character of BPD clinical course. The use of elaborated prognostic algorithms by the method of characteristic intervals allowed to receive the true prognoses in 87,6% of cases, ambiguous ones – in 8,6 %, and erroneous ones – in 3,8% of cases. The Wald-Genkin procedure revealed its higher reliability especially at erroneous prognoses.
Conclusions. The complex of postnatal factors has an essential influence of age-specific clinical course and clinical outcome of BPD that allows use it for elaboration of the highly reliable criteria of prognostication of BPD development. An establishment of the difference of threshold values of factors that determine the character of clinical course and clinical outcome of BPD allows an elaboration of prognostic sceneries including individual prognostic algorithms on every age period of patient
References
Znamenskaya, T. K. (2011). Osnovnyie problemyi i napravleniya razvitiya neonatologii na sovremennom etape razvitiya meditsinskoy pomoschi v Ukraine. NeonatologIya, hIrurgIya ta perinatalna meditsina, 1 (1), 5–9.
Sorokolat, Yu. V., Klimenko, T. M., Golubova, M. A., Korovay, S. M. (2012). K voprosu effektivnyih modeley perinatalnyih tsentrov. NeonatologIya, hIrurgIya ta perinatalna meditsina, 3, 5–7.
Albertine, K. H. (2013). Progress in understanding the pathogenesis of BPD using the baboon and sheep models. Seminars in Perinatology, 37 (2), 60–68. doi: 10.1053/j.semperi.2013.01.001
Harris, W. T., Muhlebach, M. S., Oster, R. A., Knowles, M. R., Noah, T. L. (2009). Transforming growth factor-β 1 in bronchoalveolar lavage fluid from children with cystic fibrosis . Pediatric Pulmonology, 44 (11), 1057–1064. doi: 10.1002/ppul.21079
Mourani, P. M., Abman, S. H. (2013). Pulmonary vascular disease in bronchopulmonary dysplasia. Current Opinion in Pediatrics, 25 (3), 329–337. doi: 10.1097/mop.0b013e328360a3f6
Klimenko, T. M., Agashkov, V. S. (2011). Novoe v definitsii patogeneza bronholegochnoy displazii u novorozhdennyih . Zdorove rebenka, 1 (28), Available at: http://www.mif-ua.com/archive/article/17614
Kwinta, P., Bik-Multanowski, M., Mitkowska, Z., Tomasik, T., Legutko, M., Pietrzyk, J. J. (2008). Genetic Risk Factors of Bronchopulmonary Dysplasia. Pediatric Research, 64 (6), 682–688. doi: 10.1203/pdr.0b013e318184edeb
Sorokolat, Yu. V. (2013). DosvId ta napravlennya rozvitku sistemi kompleksnoYi dopomogi sIm’yam z dItmi do 3 rokIv z porushennyami zdorovya ta rozvitku. NeonatologIya, hIrurgIya ta perinatalna meditsina, 4 (10), 19–23.
Ovsyanikov, D. Yu. (2011). Bronholegochnaya displaziya: estestvennoe razvitie, ishodyi i kontrol. Pediatriya, 1 (90), 141–149.
Shunko, E. E. (2011). Vprovadzhennya kontseptsIYi podalshogo rozvitku perinatalnoYi dopomogi v UkraYinI. NeonatologIya, hIrurgIya ta perinatalna meditsina, I (1), 10–16.
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Юрий Владимирович Сороколат
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
