Avaliação tomográfica pulmonar tardia em prematuros com displasia broncopulmonar e persistência de canal arterial

Abstract

Objective: To assess through high-resolution computed tomography, the pulmonary parenchyma of children born prematurely with both very low birth weight and patent ductus arteriosus, undergoing medical or surgical treatment who developed bronchopulmonary dysplasia. Methods: Between December 2006 and January 2007, 14 children born prematurely with a birth weight of less than 1500 g with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) were submitted to high-resolution computed tomography (HRCT). Patients were divided into two groups (Group A = medical [n=6] and Group B = surgical [n=8]) and all of them underwent surgical closure of the ductus arteriosus. The pool of patients was comprised of 9 baby boys and 5 baby girls who were 36.5±4.3 month-old. The HRCT were analyzed by two independent observers and quantified in each patient. The statistical analyses were assessed using the Mann-Whitney test and p<0.05 was considered statistically significant. Results: Three patients presented normal tomography; two of group A and one of B. In Group A, the most frequent finding was multifocal ground-glass opacity. In Group B, multifocal ground-glass opacity, atelectasis, and low attenuation areas with relatively decreased number and caliber of vessels were prevalent (62.5%). There was a statistically significant difference between both groups. Group B presented higher averages in intubation time, use of oxygen, and admission. However, as to the number of injuries found on HRCT there was no statistically significant difference (p=0.0787). Conclusion: The lately use of HRCT has shown no significant difference between both medical and surgical treatment aiming at to occlude the PDA in pulmonary parenchyma injuries of premature infants with PDA who developed bronchopulmonary dysplasia.