Reliability of a Noninvasive Measure of V./Q. Mismatch for Bronchopulmonary Dysplasia.

TitleReliability of a Noninvasive Measure of V./Q. Mismatch for Bronchopulmonary Dysplasia.
Publication TypeJournal Article
Year of Publication2015
AuthorsBamat NA, Ghavam S, Liu Y, DeMauro SB, Jensen EA, Roberts R, Yoder BA, Kirpalani H
JournalAnn Am Thorac Soc
Volume12
Issue5
Pagination727-33
Date Published2015 May
ISSN2325-6621
KeywordsBronchopulmonary Dysplasia, Female, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Male, Oxygen Consumption, Prospective Studies, Reproducibility of Results, Respiratory Function Tests, ROC Curve, Severity of Illness Index
Abstract

RATIONALE: Currently used definitions of bronchopulmonary dysplasia (BPD) lack a continuous measure of disease severity.

OBJECTIVES: To determine if an indirect measure of V./Q. mismatch is reliable when simplified to facilitate more widespread use for grading disease severity in BPD at 36 weeks postmenstrual age.

METHODS: We used prospectively collected data from 32 preterm infants undergoing an oxygen reduction test at 36 weeks postmenstrual age to perform a simplified indirect assessment of V./Q. mismatch for each infant. Independent raters applied the model, and interrater reliability for a quantitative measure of mismatch was measured by intraclass correlation coefficient. A receiver operating characteristic curve evaluated the impact of increasing degrees of V./Q. mismatch on diagnosing BPD as defined by oxygen reduction test failure.

MEASUREMENTS AND MAIN RESULTS: Concordance for the quantitative measure of V./Q. mismatch between independent raters improved from 0.72 (confidence interval [CI], 0.48-0.86) to 0.93 (CI, 0.87-0.96) after refinement of instructions for applying the simplified model. Higher degrees of mismatch were increasingly predictive of oxygen reduction test failure, with a receiver operating characteristic curve analysis area under the curve of 0.83 (CI, 0.68-0.99; Pā€‰=ā€‰0.03).

CONCLUSIONS: A simplified indirect measure of V./Q. mismatch for diagnosing and grading disease severity in BPD has high reliability and can be performed with data obtained during a standard oxygen reduction test. This should facilitate more widespread investigation of this model as a technique for characterizing BPD severity.

DOI10.1513/AnnalsATS.201410-462OC
Alternate JournalAnn Am Thorac Soc
PubMed ID25714998
PubMed Central IDPMC4418335
Grant ListU10 HD053124 / HD / NICHD NIH HHS / United States
U-0 HD053124-01 / HD / NICHD NIH HHS / United States