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Lung function and respiratory health at school age in ventilated very low birth weight infants

Gianluca Lista1, Francesca Castoldi, Silvia Bianchi

  • 1Department of NICU, V.Buzzi Children's Hospital ICP, Via Castelvetro 32, 20154, Milan, Italy, g.lista@icp.mi.it.

Indian Journal of Pediatrics
|July 23, 2013
PubMed

Insights

Very low birth weight (VLBW) infants without bronchopulmonary dysplasia (BPD) show persistent airflow limitation. Long-term respiratory follow-up is crucial for these children, regardless of initial ventilation strategy.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Infants born with very low birth weight (VLBW) and severe respiratory distress syndrome (RDS) often require mechanical ventilation.
  • Bronchopulmonary dysplasia (BPD) is a common complication, but respiratory outcomes in VLBW infants without BPD are less understood.
  • High-frequency oscillatory ventilation (HFOV) and volume guarantee (VG) ventilation are lung-protective strategies used for severe RDS.

Purpose of the Study:

  • To assess long-term respiratory health and lung function in school-aged children who were VLBW infants with severe RDS.
  • To compare respiratory outcomes between those initially randomized to HFOV versus VG ventilation.
  • To determine if lung function impairment persists in VLBW survivors without BPD.

Main Methods:

  • Observational study of 7-year-old ex-preterm infants (mean gestational age 27 weeks, mean birth weight ~1090g) with severe RDS.
  • Infants were randomized at birth to either HFOV or VG ventilation.
  • Lung function was evaluated using whole-body plethysmography and spirometry; clinical data were reviewed.

Main Results:

  • Twenty-five children (13 VG, 12 HFOV) completed the study.
  • No significant differences were observed in anthropometrics, medication use, or hospital readmissions between groups.
  • A similar obstructive deficit, characterized by elevated airway resistance and lung volumes, was found in both groups, indicating persistent airflow limitation despite the absence of BPD.

Conclusions:

  • VLBW infants, even those without BPD, frequently exhibit impaired lung function.
  • This lung function impairment appears independent of the initial respiratory support strategy (HFOV vs. VG).
  • Long-term respiratory follow-up is essential for VLBW survivors to manage potential chronic respiratory issues.
Abstract

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