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Morphometric Analysis of the Lung in Prolonged Bronchopulmonary Dysplasia

Summary: Morphometric analysis of the lungs and heart of a male infant who died at 33 months of age of bronchopulmonary dysplasia after prematurity and respiratory distress syndrome and its treatment is presented. Alveolar internal surface area was 8.4 m2 compared to 15.3–27.8 for age-matched controls. The number of alveoli was 19 X 106 (123.3–172.5 X 106 for controls); however, the mean small airway diameter, 0.44 mm was normal, and small airway abnormalities were minimal. There was marked muscular hypertrophy of the right ventricle.Speculation: Severe neonatal lung injury, with persistent oxygen dependency throughout infancy might result in inhibition or marked slowing of lung growth. Because development of conducting airways is completed early during intrauterine life and because most alveolar development takes place postnatally, one might expect disturbances in alveolar growth to overshadow residual airway injury in survivors of bronchopulmonary dysplasia.