TY - JOUR T1 - Bronchodilator responsiveness and dysanapsis in bronchopulmonary dysplasia JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00682-2021 SP - 00682-2021 AU - Leif D Nelin AU - Matthew J Kielt AU - Maria Jebbia AU - Sudarshan Jadcherla AU - Edward G Shepherd Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/05/05/23120541.00682-2021.abstract N2 - Question addressed The incidence of bronchopulmonary dysplasia (BPD) following preterm birth is increasing. Bronchodilators are often used to treat patients with BPD with little evidence to guide therapy. To test the hypothesis that there are infant pulmonary function test (iPFT) parameters that can predict subsequent bronchodilator response in infants with BPD.Methods Subjects in this study are part of a patient group in whom we reported 3 BPD phenotypes (obstructive, restrictive and mixed) based on iPFT data. From that group, a cohort of 93 patients with iPFT data including bronchodilator response were eligible for this study.Results Bronchodilator responsiveness was found in 59 (63%) of the cohort. There were no differences in demographics between the responders and non-responders. There was no difference in forced vital capacity (FVC) between the two groups. Responders had significantly lower FEV0.5 and FEV0.5/FVC (p<0.005) and greater indices of hyperinflation than did non-responders (p<0.005). Logistic regression modeling found that pre-bronchodilator FEV0.5 and FRC/TLC were significantly associated with bronchodilator response. The magnitude of response to bronchodilators was negatively correlated (R = −0.49; R2 = 0.24; p<0.001) with the FEV0.5. The median dysanapsis ratio in responders (0.08; 95% CI 0.05–0.19) was significantly (p = 0.005) smaller than in non-responders (0.18; 95% CI 0.06–0.38).Answer to the question These findings demonstrate that there are pulmonary function test parameters associated with bronchodilator response. Responders had evidence of greater dysanaptic lung growth than do non-responders.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of Interest Disclosures: The authors have no conflicts of interest relevant to this article to disclose. ER -