Higgins et al reported criteria for grading the severity of Bronchopulmonary Dysplasia (BPD) at a NICHD workshop.
Selection criteria:
(1) premature infant (born < 32 weeks gestation)
(2) bronchopulmonary dysplasia
(3) persistent parenchymal lung disease with radiographic confirmation
Criterion for grading: Oxygen use at 36 weeks postmenstrual age (PMA) with oxygen delivery FIO2 given for >= 3 consecutive days to maintain arterial oxygen saturation in the 90-95%
Modalities and FIO2:
(1) invasive positive pressure ventilation (IPPV)
(2) N-CPAP
(3) noninvasive positive pressure ventilation (NIPPV)
(4) nasal cannula
(5) hood oxygen
Modality |
Other |
FIO2 |
Grade |
IPPV |
|
21 (room air) |
II |
|
|
> 21 |
III |
N-CPAP |
|
21 |
I |
|
|
22-29 |
II |
|
|
>= 30 |
III |
NIPPV |
|
21 |
I |
|
|
22-29 |
II |
|
|
>= 30 |
III |
nasal cannula |
1 to 2.99 L/min |
22-29 |
I |
|
1 to 2.99 L/min |
>= 30 |
II |
|
>= 3 L/min |
21 |
I |
|
>= 3 L/min |
22-29 |
II |
|
>= 3 L/min |
>= 30 |
III |
|
< 1 L/min |
22-70 |
I |
|
< 1 L/min |
> 70 |
II |
hood oxygen |
|
22-29 |
I |
|
|
>= 30 |
II |
Grade III(A) designates early death (between 14 days of postnatal age and 36 weeks PMA) owing to persistent parenchymal lung disease and respiratory failure not attributable to another cause.