European Journal of Pediatrics

, Volume 163, Issue 1, pp 14–18 | Cite as

Prediction of outcome from the chest radiograph appearance on day 7 of very prematurely born infants

  • Anne Greenough
  • Mark Thomas
  • Gabriel Dimitriou
  • Olivia Williams
  • Alice Johnson
  • Elizabeth Limb
  • Janet Peacock
  • Neil Marlow
  • Sandra Calvert
Original Paper

Abstract

Our aim was to determine whether the chest radiograph appearance at 7 days predicted chronic lung disease development (oxygen dependency at 36 weeks post-menstrual age) or death before discharge and if it was a better predictor than readily available clinical data. Two consecutive studies were performed. In both, chest radiographs taken at 7 days for clinical purposes were assessed using a scoring system for the presence of fibrosis/interstitial shadows, cystic elements and hyperinflation and data were collected regarding gestational age, birth weight, use of antenatal steroids and post-natal surfactant and requirement for ventilation at 7 days. Oxygenation indices were calculated in the first study (study A) at 120 h and in the second (study B) at 168 h. In study A, there were 59 infants with a median gestational age of 26 weeks (range 24 to 28 weeks) and in study B, 40 infants with a median gestational age of 27 weeks (range 25–31 weeks). In both studies, infants who developed chronic lung disease had a significantly higher total chest radiograph score, with a higher score for fibrosis/interstitial shadowing than the rest of the cohort. Infants who died before discharge differed significantly from the rest with regard to significantly higher scores for cysts. In both studies, the areas under the receiver operator characteristic curves with regard to prediction of chronic lung disease were higher for the total chest radiograph score compared to those for readily available clinical data. Conclusion:in infants who require a chest radiograph for clinical purposes at 7 days, the chest radiograph appearance can facilitate prediction of outcome of infants born very prematurely.

Keywords

Chest radiograph Chronic lung disease 

Abbreviations

CLD

chronic lung disease

CXR

chest radiograph

CMV

conventional mechanical ventilation

HFO

high frequency oscillation

KCH

King’s College Hospital

OI

oxygenation index

PIE

pulmonary intestinal emphysema

PMA

post-menstrual age

ROC

receiver operator characteristic curves

UKOS

United Kingdom Oscillation Study

Notes

Acknowledgements

Drs Thomas and Johnson and Mrs E Limb were supported by the Medical Research Council. The UKOS trial is funded by the Medical Research Council. Drs Dimitriou and Williams were supported by Children Nationwide.

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Anne Greenough
    • 1
  • Mark Thomas
    • 1
  • Gabriel Dimitriou
    • 1
  • Olivia Williams
    • 1
  • Alice Johnson
    • 2
  • Elizabeth Limb
    • 3
  • Janet Peacock
    • 3
  • Neil Marlow
    • 4
  • Sandra Calvert
    • 2
  1. 1.Department of Child Health, Guy’s, King’s and St Thomas’ School of MedicineKing’s College HospitalLondon UK
  2. 2.Department of Child HealthSt George’s Hospital Medical SchoolLondon UK
  3. 3.Department of Public Health SciencesSt George’s Hospital Medical SchoolLondon UK
  4. 4.Department of Child HealthUniversity HospitalNottingham UK

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