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Functional residual capacity and static compliance during the first year in preterm infants treated with surfactant
J P de Winter1, I T Merth, R Brand
1Department of Pediatrics, Leiden University Medical Centre, The Netherlands.
Insights
Surfactant treatment supports lung development in preterm infants. Infants without chronic lung disease showed similar lung function to controls, indicating positive outcomes for respiratory distress syndrome recovery.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Preterm birth complications like respiratory distress syndrome (RDS) necessitate interventions.
- Surfactant therapy is a standard treatment for RDS in neonates.
- Chronic lung disease of the newborn (CLDN) is a potential complication following RDS.
Purpose of the Study:
- To assess long-term lung development in surfactant-treated preterm infants with and without CLDN.
- To compare lung function trajectories between infants with RDS, CLDN, and healthy controls.
- To evaluate the impact of surfactant treatment on functional residual capacity (FRC) and respiratory system compliance (Crs) over the first year of life.
Main Methods:
- Longitudinal study of lung function in preterm infants (n=21) treated with surfactant for RDS, including those who developed CLDN (n=6) and controls (n=18).
- Measurements of functional residual capacity (FRC) using helium dilution and static respiratory system compliance (Crs) using a weighted spirometer.
- Pulmonary function tests conducted at term-equivalent age and at 4, 8, and 12 months post-treatment.
Main Results:
- At term-equivalent age, FRC was significantly lower in the CLDN group compared to uncomplicated RDS and control groups (p < 0.05).
- No significant differences in FRC development were observed between groups throughout the first year (p = 0.4).
- Infants recovering from RDS without CLDN showed similar Crs development to controls, while the CLDN group exhibited lower Crs values (p < 0.05).
Conclusions:
- Surfactant treatment leads to comparable lung development in preterm infants without CLDN to that of healthy controls.
- Early FRC is reduced in infants who develop CLDN, though its developmental trajectory normalizes.
- Respiratory system compliance is maintained in surfactant-treated infants recovering from RDS, but remains lower in those developing CLDN.
Abstract:
Individual lung development during the first year of life was studied in surfactant treated preterm infants with respiratory distress syndrome (RDS) and healthy controls, as well as in a group who subsequently developed chronic lung disease of the newborn (CLDN). Lung development was assessed from functional residual capacity (FRC) and compliance of the respiratory system (Crs). Twenty-one infants with RDS after preterm birth received surfactant treatment. Six of them developed CLDN. Eighteen preterm infants without RDS served as a control group. Lung function measurements were performed at term age and 4, 8, and 12 months afterwards. FRC was obtained by means of the closed-system helium dilution technique whereas static Crs was obtained by means of the weighted spirometer technique. At term age, FRC was lower in the CLDN group compared with uncomplicated RDS and controls (p < 0.05). No significant differences between groups were found in the development of FRC during the first year of life (p = 0.4). No differences were found in Crs during the first year of life in surfactant treated infants who recovered from uncomplicated RDS and the control group. However, lower values were found in the CLDN group (p < 0.05). We conclude that surfactant treated infants without CLDN have similar lung development during the first year of life as control preterm infants.