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Lung function measured by the oscillometric method in prematurely born children with chronic lung disease
L P Malmberg1, S Mieskonen, A Pelkonen
1Dept of Allergic Diseases, Helsinki University Central Hospital, Finland.
Insights
The forced oscillation technique effectively evaluates lung function in children born prematurely, identifying chronic lung disease. This method offers an alternative to conventional spirometry for early detection in clinical and research settings.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Premature birth is linked to persistent chronic respiratory morbidity into school age.
- Evaluating lung function in preschool children is challenging due to limited cooperation with conventional methods.
Purpose of the Study:
- To investigate oscillometric findings in school-aged children born prematurely.
- To compare the forced oscillation technique with conventional lung function tests in this population.
Main Methods:
- The study included 49 school-aged children born prematurely (with or without chronic lung disease) and 18 healthy controls.
- Lung function was assessed using the forced oscillation technique and conventional spirometry/body plethysmography.
Main Results:
- Children with chronic lung disease showed higher respiratory resistance and lower reactance.
- Oscillometric parameters correlated significantly with spirometry (FEV1) and body plethysmography (Raw).
- The forced oscillation technique provided concordant information on lung function deficits, particularly in detecting peripheral airway obstruction.
Conclusions:
- The forced oscillation technique is a suitable alternative for early lung function evaluation in children born prematurely, especially those with chronic lung disease.
- Oscillometry can identify airway obstruction in this population where conventional methods may be unsuitable.
Abstract:
Premature birth is related to a chronic respiratory morbidity, which may persist until school-age. In these children, the forced oscillation technique would be suitable for evaluation of lung function even at preschool age, since it requires only minimal patient cooperation. In order to investigate the oscillometric findings related to premature birth, using the oscillation technique and conventional lung function methods 49 school-aged children born prematurely with (n=15) or without (n=34) chronic lung disease (CLD), and 18 healthy children born at full term were studied. Children with CLD had higher respiratory resistance (Rrs,5) and lower reactance (Xrs,5) than prematurely born children without CLD or healthy controls. Both Rrs,5 (r=-0.55, p<0.0001) and Xrs,5 (r=0.76, p<0.0001) were significantly associated with forced expiratory volume in one second (FEV1), the agreement with spirometry being better in Xrs,5 than in Rrs,5 (p=0.02). Rrs,5 was significantly related to airway resistance (Raw) measured by body plethysmography (r=0.63, p<0.0001), but underestimated resistance at high values of Raw. There was no significant relationship between the pulmonary diffusing capacity and the oscillometric findings. Compared to conventional methods, the oscillometric method yields concordant information on the severity of lung function deficit in children born prematurely, with or without chronic lung disease. In these children, the oscillometric findings are probably due to peripheral or more widespread airway obstruction. As conventional methods are not usually suitable for preschool children, oscillometry may serve as an alternative for early evaluation of chronic lung disease among children with premature birth in clinical or research settings.