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Franchi S., Fommei C., Strambi M.
Department of Pediatrics, Obstetrics and Reproductive Medicine, Le Scotte Polyclinic, University of Siena, Siena, Italy
AIM: To evaluate the respiratory outcome and to estimate the risk of asthma in adolescents with perinatal history of bronchopulmonary dysplasia (BPD), who now play sports fairly regularly.
METHODS: We enrolled seven adolescents with a history of BPD, six were preterm (g.a. 25-30 weeks), with a weight between 840-1400 gr. Nitric oxide (NO) was measured with NIOX MINO ®; MS-IOS Jaeger spirometer was used for the analysis of pulmonary volumes.
RESULTS: Five adolescents showed a height >10°percentile; in four cases a delayed neurological outcome was found: three of them, with prolonged postnatal oxygen therapy, showed a predisposition to respiratory infections in the first two years of life; in two adolescent with familiar history of allergies, was found a bronchial iperreactivity, induced by physical activity. In six cases spirometry did not show the typical tendency of an obstructive syndrome. Two patients affected by acute nasopharyngitis showed high values of NO and one of them was symptomatic during the stimulation (physical activity and methacholine test).
CONCLUSION: The therapeutic strategies after 1990 seem to assure a good respiratory outcome in adolescents: there were not permanent pulmonary consequences or increased risk of asthma in our cases; bronchial iperreactivity seems to be linked to allergic diathesis. The high values of EFNO doesn’t seem to be linked to a low respiratory tract phlogosis as a prodrome of asthma, but to episodes of acute phlogosis of high respiratory ways. The onset of asthma is possible in the adolescent with positive methacholine test and familiar history of allergies.