Conflict of interest: None.
Postmortem lung volume/body weight standards for term and preterm infants
Article first published online: 29 AUG 2013
Copyright © 2013 Wiley Periodicals, Inc.
Volume 49, Issue 1, pages 60–66, January 2014
How to Cite
De Paepe, M. E., Shapiro, S., Hansen, K. and Gündoğan, F. (2014), Postmortem lung volume/body weight standards for term and preterm infants. Pediatr. Pulmonol., 49: 60–66. doi: 10.1002/ppul.22818
- Issue published online: 16 DEC 2013
- Article first published online: 29 AUG 2013
- Manuscript Accepted: 6 APR 2013
- Manuscript Received: 5 APR 2013
- none reported
- lung hypoplasia;
- lung growth;
- congenital diaphragmatic hernia;
- rupture of membranes;
Assessment of lung growth is a critical component of the perinatal autopsy. Increased lung liquid content may lead to overestimation of lung growth based on (wet) lung weight. In contrast, lung volume is not influenced by intraalveolar lung liquid. Our aim was to establish age-specific reference values for postmortem lung volume/BW in preterm and term infants. We performed a retrospective analysis of fetuses/infants (16–41 weeks' gestation) without (N = 134) or with (N = 79) risk factors for pulmonary hypoplasia. Lungs were inflated at standardized pressure and volumes determined by water immersion method. Lung volume increased 11-fold between 16 and 41 weeks' gestation, concomitant with a 16-fold increase in BW. Mean lung volume/BW remained constant at 33–34 ml/kg between 16 and 31 weeks' gestation and decreased to 23.4 ml/kg at term. Lung volume/BW of infants with severe risk factors (renal anomalies, diaphragmatic hernia) was significantly lower than age-matched standards. In this group, all fetuses/infants diagnosed as having lung hypoplasia by lung volume/BW also had lung hypoplasia LW/BW standards. However, in infants with “softer” risk factors (rupture of membranes, chromosomal anomalies), 5/26 cases diagnosed with lung hypoplasia based on lung volume/BW had normal LW/BW ratios. In these discrepant cases, lung sections showed significant inflammation and edema, likely accounting for increased wet lung weight. In conclusion, we determined age-specific lung volume/BW reference values for preterm and term infants. In selected situations assessment of lung volume/BW may represent a useful complementary tool to LW/BW for postmortem evaluation of lung size. Pediatr Pulmonol. 2014; 49:60–66. © 2013 Wiley Periodicals, Inc.